Podcasts about Cochrane

We talk Damion Hall saying Guy is the best male R&B group EVER (not), Essencefest, Zohran Mamdami, Beyonce’s Cowboy Carter tour, Philly is smelly, and Dr. Cheyenne Bryant tells us she’s in a situationship. Enjoy!!!! The post Damion Go Sit Down first appeared on The Poplife Podcast.

Investi con ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Scalable⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠, 3,5% di interessi sulla liquidità (*) (#adv) . Come possono coesistere le tesi dell'investimento passivo con una gestione dinamica dell'asset allocation? Come adattare il portafoglio a diversi scenari di lungo termine del mercato senza cadere nel market timing? Perché le azioni possono essere considerate come dei bond? Asset allocation con regola di Merton (scaricare una copia) A. Ilmanen, Understanding Expected Returns, P. 1, P. 2, P. 3, P. 4 J. Cochrane, Discount Rates =============================================== Investi con ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Fineco⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠, 60 trade gratis nei primi tre mesi con il codice ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠TRD060-TB⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Prova gratis la newsletter di ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠DataTrek⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ per 15 giorni. Naviga in totale sicurezza con ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠NordVPN⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Migliaia di libri audioriassunti su ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠4Books⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠. I link sono sponsorizzati e l'Autore potrebbe percepire una commissione. (*) fino al 31/12/2025, offerta valida per i nuovi clienti. Si applicano termini e condizioni. =============================================== ATTENZIONE: I contenuti di questo canale hanno esclusivamente finalità di informare e intrattenere. Le informazioni fornite sul canale hanno valore indicativo e non sono complete circa le caratteristiche dei prodotti menzionati. Chiunque ne faccia uso per fini diversi da quelli puramente informativi cui sono destinati, se ne assume la piena responsabilità. Tutti i riferimenti a singoli strumenti finanziari non devono essere intesi come attività di consulenza in materia di investimenti, né come invito all'acquisto dei prodotti o servizi menzionati. Investire comporta il rischio di perdere il proprio capitale. Investi solo se sei consapevole dei rischi che stai correndo. Learn more about your ad choices. Visit megaphone.fm/adchoices

We've got some wild and occasionally disturbing Star Trek episodes this week, episodes that also introduce us to a couple of very important characters. First up it's the father of the space warp in Metamorphosis, then we spend some quality time with Spock's folks in Journey to Babel! CHAPTERS: (00:00:00) - The Nextlander Watchcast Episode 142: Star Trek: Metamorphosis and Journey to Babel (00:00:30) - Intro. (00:02:09) - Launching right into Metamorphosis, and some of our beefs with it. (00:06:42) - Production notes (and several asides about Cochrane and warp drive). (00:16:11) - Our guest stars this week. (00:19:03) - Kicking the episode off proper with a stranded shuttle and a pissed off commissioner.  (00:25:44) - Running afoul of a psychedelic space cloud. (00:27:42) - Zefram Cochrane? Here? Now? (00:32:43) - The commissioner gets pissy, and Nimoy does a stunt roll. (00:37:09) - What is the Enterprise up to during all of this, and now it's time to talk to the Companion. (00:42:15) - Cochrane's turn. (00:48:34) - Kirk's last big plea, and the Companion decides to become a human lady. (00:57:40) - Final thoughts. (00:59:24) - Break! (00:59:48) - We're back, and it's time to Journey to Babel. (01:04:15) - Production notes. (01:12:00) - Cast chat. (01:20:12) - A diplomat AND a parent. (01:28:41) - Some special effects talk, and meeting a room full of alien diplomats. (01:38:20) - The mysterious vessel of the week, and murder is afoot. (01:43:39) - Kirk gets shanked, and Spock's command snafu. (01:49:50) - Kirk's ruse, Sarek's surgery, and when an Andorian is not an Andorian. (01:55:52) - Sarek is saved! (02:01:01) - Final thoughts. (02:05:30) - Next week's episodes, scheduling housekeeping, and outro.

Daniel Cochrane, Senior Research Associate for the Center for Technology and the Human Person at The Heritage Foundation. Senate Overwhelmingly Rejects AI Moratorium

The Lord's Own Prayer, Part 3 - Dan Cochrane

Jamie Hartmann-Boyce and Nicola Lindson interview Lauren McMillan, University of Stirling about her project evaluating the effectiveness of an e-cigarette intervention for smoking cessation at centres for people experiencing or at risk of homelessness. Associate Professor Jamie Hartmann-Boyce and Associate Professor Nicola Lindson discuss the new evidence in e-cigarette research and interview Lauren McMillan from the Institute for Social Marketing and Health (ISMH) at the University of Stirling. In the June podcast Lauren discusses Project SCeTCH - a cluster RCT that evaluates the effectiveness of an e-cigarette intervention vs usual care at centres for people experiencing or at risk of homelessness. The study measures smoking abstinence over a 6 month follow-up period and includes embedded process and economic evaluations. If effective, the results will be used to inform the larger-scale implementation of offering e-cigarettes throughout centres for people experiencing or at risk of homelessness to aid smoking cessation. Lauren is part of the research team, led by Dr Allison Ford at the University of Stirling, that conducted the process evaluation of the SCeTCH trial . The main SCeTCH trial was led by Professor Lynne Dawkins (London Southbank University) and Dr Sharon Cox (University College London). This podcast is a companion to the electronic cigarettes Cochrane living systematic review and Interventions for quitting vaping review and shares the evidence from the monthly searches. Our search for the EC for smoking cessation review carried out on 1st June 2025 found 1 ongoing study: https://clinicaltrials.gov/study/NCT06948058 Our search for our interventions for quitting vaping review up to 1st June 2025 found 2 new (DOI 10.1093/ntr/ntaf112; 10.1016/j.amepre.2025.107664) and 2 linked papers (DOI: 10.2196/72002; 10.1016/j.cct.2025.107958) For further details see our webpage under 'Monthly search findings': https://www.cebm.ox.ac.uk/research/electronic-cigarettes-for-smoking-cessation-cochrane-living-systematic-review-1 For more information on the full Cochrane review of E-cigarettes for smoking cessation updated in January 2025 see: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010216.pub9/full For more information on the full Cochrane review of Interventions for quitting vaping published in January 2025 see: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD016058.pub2/full This podcast is supported by Cancer Research UK.

Mit einem Knall wurde eine neue Studie, ein sogenanntes Cochrane Review veröffentlicht und viele evidenzbasierte Physio Influenzer stürzten sich darauf.Die Studie mit dem Titel "Sind Kräftigungsübungen eine sinnvolle Maßnahme zur Behandlung von Menschen mit Patellasehnen-Tendinopathie (Patellaspitzensyndrom)?" stellt die aktuelle Studienlage sehr kritisch dar.Gibt es überhaupt Belege für das, was wir tun? Hilft Krafttraining am Ende gar nicht und wir hatten bisher einfach nur Glück?Frank Taeger, Organisationspsychologe und der Mensch mit dem besten Verständnis von wissenschaftlichen Studien und deren Einordnung, den ich (Nils) kenne, hilft uns, diese Studie zu analysieren und Licht ins Dunkel zu bringen.Hier findest du Franks Bücher über Training und Ernährung, die ich wärmstens empfehlen kann:https://www.taegerfitness.de/produkte/Hier der Link zur Studie:https://www.cochrane.org/de/node/8236Wenn du selbst von Patella- oder Achillessehnen Schmerzen betroffen bist und diese endlich los werden möchtest, dann sichere dir jetzt einen Termin für unsere kostenlose Schmerzanalyse, in der wir darüber sprechen, ob wir dir weiterhelfen können.Hier kostenlosen Termin buchen:https://nilsheim.de/termin

Summary In this episode of the Pain Exam Podcast, Dr. David Rosenblum provides a comprehensive review of herpes zoster and postherpetic neuralgia (PHN), focusing on pathophysiology, diagnosis, and treatment options. Dr. Rosenblum explains that postherpetic neuralgia affects approximately 25% of patients with acute herpes zoster, causing debilitating unilateral chronic pain in one or more dermatomes. He discusses the three phases of herpes zoster: acute (up to 30 days), subacute (up to 3 months), and postherpetic neuralgia (pain continuing beyond 3 months). Dr. Rosenblum identifies risk factors for developing PHN, including older age, female sex, immunosuppression, prodromal pain, severe rash, and greater acute pain severity. He details the pathophysiology involving peripheral and central sensitization, and explains different phenotypes of PHN that can guide treatment approaches. For treatment, Dr. Rosenblum reviews various options including antiviral medications (which should be started within 72 hours of onset), corticosteroids, opioids, antidepressants (particularly tricyclics and SNRIs), antiepileptics (gabapentin and pregabalin), topical agents (lidocaine and capsaicin), and interventional procedures such as epidural injections and pulsed radiofrequency. He emphasizes that prevention through vaccination with Shingrix is highly effective, with 97% effectiveness in preventing herpes zoster in patients 50-69 years old and 89% effectiveness in those over 70. Dr. Rosenblum mentions that he's currently treating a patient with trigeminal postherpetic neuralgia and is considering a topical sphenopalatine ganglion block as a minimally invasive intervention before attempting more invasive procedures. Chapters Introduction to the Pain Exam Podcast and Topic Overview Dr. David Rosenblum introduces the Pain Exam Podcast, mentioning that it covers painful disorders, alternative treatments, and practice management. He explains that this episode focuses on herpes zoster and postherpetic neuralgia as board preparation for fellows starting their programs, with ABA boards coming up in September. Dr. Rosenblum notes that he's not only preparing listeners for boards but also seeking the latest information to help treat his own patients with this notoriously difficult disease. Upcoming Conferences and Educational Opportunities Dr. Rosenblum announces several upcoming conferences including Aspen in July, Pain Week in September, and events with NYSIP and the Latin American Pain Society. He mentions he'll be teaching ultrasound and regenerative medicine at these events. Dr. Rosenblum invites listeners to sign up at nrappain.org to access a community discussing regenerative medicine, ultrasound-guided pain medicine, regional anesthesia, and board preparation. He also offers ultrasound training in New York and elsewhere, with upcoming sessions in Manhattan on July 12th and October 4th, plus private shadowing opportunities. Overview of Postherpetic Neuralgia Dr. Rosenblum defines postherpetic neuralgia as typically a unilateral chronic pain in one or more dermatomes after acute herpes zoster infection. He states that the incidence of acute herpes zoster ranges between 3-5 patients per thousand person-years, and one in four patients with acute herpes zoster-related pain will transition into postherpetic neuralgia. Dr. Rosenblum emphasizes that while this condition won't kill patients, it can be extremely debilitating and significantly reduce quality of life. Treatment Options Overview Dr. Rosenblum reviews treatment options according to the WHO pain ladder, including tricyclics like nortriptyline and antiepileptic drugs such as gabapentin. He explains that if pain is not significantly reduced, interventional treatments like epidural injections with local anesthetics and corticosteroids or pulsed radiofrequency of the dorsal root ganglion are options. For postherpetic neuralgia specifically, Dr. Rosenblum notes that preferred treatments include transdermal capsaicin, lidocaine, or oral drugs such as antidepressants or antiepileptics. Phases of Herpes Zoster and Definitions Dr. Rosenblum outlines the three phases during herpes zoster reactivation: acute herpes zoster-related pain (lasting maximum 30 days), subacute herpes zoster-related pain (pain after healing of vesicles but disappearing within 3 months), and postherpetic neuralgia (typically defined as pain continuing after 3 months). He mentions that acute herpes zoster pain often begins with prodromal pain starting a few days before the appearance of the rash. Incidence and Risk Factors Dr. Rosenblum states that the incidence of herpes zoster ranges between 3-5 patients per 1,000 person-years, with approximately 5-30% of cases leading to postherpetic neuralgia. He identifies risk factors including older age, female sex, immunosuppression, prodromal pain, severe rash, and greater acute pain severity. Dr. Rosenblum describes the clinical manifestations as a mosaic of somatosensory symptoms including burning, deep aching pain, tingling, itching, stabbing, often associated with tactile and cold allodynia. Impact on Quality of Life Dr. Rosenblum emphasizes that postherpetic neuralgia can be debilitating, impacting both physical and emotional functioning and causing decreased quality of life. He notes that it leads to fatigue, insomnia, depression, anorexia, anxiety, and emotional distress. Dr. Rosenblum stresses the importance of exploring methods for prevention of postherpetic neuralgia and optimizing pain treatment for both subacute herpes zoster-related pain and postherpetic neuralgia. Literature Review and Pathophysiology Dr. Rosenblum mentions that he's discussing a literature review from 2024 that updates previous practical guidelines published in 2011. He explains the pathophysiology of postherpetic neuralgia, which involves sensitization of peripheral and sensory nerves from damage. Dr. Rosenblum describes how inflammatory mediators reduce the stimulus threshold of nociceptors and increase responsiveness, resulting in pathological spontaneous discharges, lower thresholds for thermal and mechanical stimuli, and hyperalgesia. Central Sensitization and Nerve Damage Dr. Rosenblum explains that central sensitization results from peripheral nociceptor hyperactivity leading to plastic changes in the central nervous system, involving amplification of pain signals and reduced inhibition. He describes how nerve damage in postherpetic neuralgia patients results from neuronal death due to severe inflammatory stimuli or secondary to neuronal swelling. Dr. Rosenblum notes that motor defects occur in 0.05% of patients with herpes zoster, observed as abdominal pseudohernias or motor weakness of limbs limited to the affected myotome. Different Phenotypes and Classification Dr. Rosenblum discusses different phenotypes of postherpetic neuralgia and how phenotyping can determine treatment. He explains that there are several ways to classify the phenotypes, with one categorizing patients into three subtypes: sensory loss (most common), thermal gain, and thermal loss with mechanical gain. Dr. Rosenblum describes the mechanistic categorization, including the irritable nociceptive phenotype characterized by preserved sensation, profound dynamic mechanical allodynia, reduced pressure pain threshold, and relief with local anesthetic infiltration. Deafferentation Phenotype Dr. Rosenblum explains that a deafferentation phenotype may arise from destruction of neurons by the virus in the dorsal root ganglion. This phenotype is characterized by sensory loss, including thermal and vibratory sensation without prominent thermal allodynia. He notes that mechanical allodynia can occur secondary to A-beta fibers activating spinothalamic pathways (known as phenotypic switches), along with pressure hyperalgesia and temporal summation suggesting central sensitization. Dr. Rosenblum mentions that in one study, this phenotype was present in 10.8% of individuals, and for those with deafferentation pain, gabapentinoids, antidepressants, and neuromodulatory therapies like repetitive transcranial magnetic stimulation may be beneficial. Diagnosis and Physical Examination Dr. Rosenblum discusses the diagnosis of herpes zoster and postherpetic neuralgia, emphasizing the importance of physical examination. He explains that diagnosis is based on the rash, redness, papules, and vesicles in the painful dermatomes, with healing vesicles showing crust formation. Dr. Rosenblum notes that the rash is generally unilateral and does not cross the midline of the body. In postherpetic neuralgia patients, he mentions that scarring, hyper or hypopigmentation is often visible, with allodynia present in 45-75% of affected patients. Sensory Testing and Assessment Dr. Rosenblum explains that in patients with postherpetic neuralgia, a mosaic of somatosensory alterations can occur, manifesting as hyperalgesia, allodynia, and sensory loss. These can be quantified by quantitative sensory testing, which assesses somatosensory functions, dermal detection thresholds for perception of cold, warmth, and paradoxical heat sensations. He notes that testing can provide clues regarding underlying mechanisms of pain, impaired conditioned pain modulation, temporal summation suggesting central sensitization, and information about the type of nerve damage and surviving afferent neurons. Prevention Through Vaccination Dr. Rosenblum discusses prevention of acute herpes zoster through vaccination, noting that the risk increases with reduced immunity. He highlights studies evaluating Shingrix, a vaccine for herpes zoster, which showed 97% effectiveness in preventing herpes zoster in patients 50-69 years old with healthy immune systems and 89% effectiveness in patients over 70. Dr. Rosenblum states that Shingrix is 89-91% effective in preventing postherpetic neuralgia development in patients with healthy immune systems and 68-91% effective in those with weakened or underlying conditions. Treatment Objectives Dr. Rosenblum outlines the treatment objectives for herpes zoster and postherpetic neuralgia. For acute herpes zoster, objectives include relieving pain, reducing severity and duration of pain, accelerating recovery of epidermal defects, and preventing secondary infections. For postherpetic neuralgia, the objectives are pain alleviation and improved quality of life. Dr. Rosenblum lists available treatments including psychotherapy, opiates, antidepressants, antiepileptics, NMDA antagonists, topical agents, and interventional treatments such as epidurals, pulsed radiofrequency, nerve blocks, and spinal cord stimulation. Antiviral Medications Dr. Rosenblum emphasizes that antiviral drugs should be started within 72 hours of clinical onset, mentioning famciclovir, valacyclovir, and acyclovir. He notes there is no evidence for effectiveness after 72 hours in patients with uncomplicated herpes zoster. Dr. Rosenblum provides dosing information: for immunocompetent patients, famciclovir 500mg and valacyclovir 1000mg three times daily for seven days; for immunocompromised patients, famciclovir 1000mg three times daily for 10 days, while acyclovir should be given IV in the immunocompromised. Benefits of Antiviral Therapy Dr. Rosenblum explains that antiviral medication accelerates the disappearance of vesicles and crusts, promotes healing of skin lesions, and prevents new lesions from forming. By inhibiting viral replication, he notes that antiviral therapy likely reduces nerve damage, resulting in reduced incidence of postherpetic neuralgia, and should be started as soon as possible. Corticosteroids and Opioids Dr. Rosenblum discusses the use of corticosteroids, noting that when added to antiviral medications, they may reduce the severity of acute herpes zoster-related pain, though increased healing of skin lesions was not observed in one study. He mentions that a Cochrane review found oral corticosteroids ineffective in preventing postherpetic neuralgia. Regarding opioids, Dr. Rosenblum states they are commonly used alongside antivirals for controlling acute herpes zoster pain, with tramadol having a number needed to treat (NNT) of 4.7 and strong opioids having an NNT of 4.3 for 50% pain reduction. Methadone and Antidepressants Dr. Rosenblum discusses methadone as an NMDA receptor antagonist used in acute and chronic pain management, though he notes there are no randomized controlled trials determining its efficacy in acute herpes zoster pain or postherpetic neuralgia. He explains that methadone can modulate pain stimuli by inhibiting the uptake of norepinephrine and serotonin, resulting in decreased development of hyperalgesia and opioid tolerance, but has side effects including constipation, nausea, sedation, and QT prolongation that can trigger torsades de pointes. Dr. Rosenblum identifies antidepressants as first-line therapy for postherpetic neuralgia, including tricyclics and SNRIs, with tricyclics having an NNT of 3 and SNRIs an NNT of 6.4 for 50% pain reduction. Antiepileptics and Pharmacological Treatment Summary Dr. Rosenblum discusses antiepileptics like gabapentin and pregabalin for postherpetic neuralgia. He cites two trials measuring gabapentin's effect, concluding it was effective compared to placebo with a pooled NNT of 4.4, while pregabalin had an NNT of 4.9. Dr. Rosenblum summarizes that pharmacological treatment is well established for subacute herpes zoster pain, though new high-quality evidence has been lacking since the last update in 2011. Topical Agents Dr. Rosenblum discusses local anesthetic topical agents including lidocaine and capsaicin creams and patches. He notes that 8% capsaicin provided significant pain reduction during 2-8 weeks, while 5% lidocaine patches provided moderate pain relief after eight weeks of treatment. Dr. Rosenblum also mentions acute herpes zoster intracutaneous injections, citing a study where single intracutaneous injection with methylprednisolone combined with ropivacaine versus saline alone showed significant difference in VAS score at 1 and 4 weeks post-intervention favoring the intervention group. Intracutaneous Injections Dr. Rosenblum discusses the effect of repetitive intracutaneous injections with ropivacaine and methylprednisolone every 48 hours for one week. He cites a randomized control trial comparing antivirals plus analgesics to antivirals plus analgesics and repeat injections, finding the intervention group had significantly shorter duration of pain, lower VAS scores, and lower incidence of postherpetic neuralgia (6.4% vs 28% at 3 months). Dr. Rosenblum notes that a potential side effect of cutaneous methylprednisolone injection is fat atrophy, though this wasn't reported in the study. Summary of Local Anesthetics Dr. Rosenblum summarizes that there are no new studies reporting the efficacy of capsaicin 8% for postherpetic neuralgia, but it remains widely used in clinical practice and is approved in several countries. He notes that lidocaine patches can reduce pain intensity in patients with postherpetic neuralgia but may be more beneficial in patients with allodynia. Dr. Rosenblum adds that intracutaneous injections may be helpful for short periods, while repetitive injections with local anesthetics may reduce VAS scores for up to six months but can cause subcutaneous fat atrophy. Interventional Treatments: Epidural and Paravertebral Injections Dr. Rosenblum discusses interventional treatments, noting that previous guidelines found epidural injection with corticosteroids and local anesthetic as add-on therapy superior to standard care alone for up to one month in managing acute herpes zoster pain. He mentions a randomized controlled trial showing no difference between interlaminar and transforaminal epidural steroid injections for up to three months after the procedure. Dr. Rosenblum adds that previous guidelines reported high-quality evidence that paravertebral injections of corticosteroids or local anesthetic reduces pain in the active phase of herpes zoster. Comparative Studies on Injection Approaches Dr. Rosenblum discusses a trial comparing efficacy of repetitive paravertebral blocks with ropivacaine versus dexmedetomidine to prevent postherpetic neuralgia, which showed significantly lower incidence of zoster-related pain one month after therapy in the dexmedetomidine group, with effects still significant at three months. He also mentions a study comparing steroid injections administered via interlaminar versus transforaminal approaches, finding both groups had significantly lower VAS scores at 1 and 3 months follow-up compared to baseline, though this could align with the natural course of herpes zoster. Timing of Interventions and Continuous Epidural Blockade Dr. Rosenblum cites a retrospective study showing that transforaminal epidural injections administered for acute herpes zoster-related pain were associated with significantly shorter time to pain relief compared to those performed in the subacute phase. He also mentions a randomized controlled trial finding that continuous epidural blockade combined with opioids and gabapentin reduced NRS pain scores more than analgesic drug treatments alone during three-day follow-up, though both studies were low-quality. Interventions for Postherpetic Neuralgia Dr. Rosenblum discusses interventions specifically for postherpetic neuralgia, citing a small randomized controlled trial that demonstrated decreased NRS pain scores six months post-treatment for repeat versus single epidural steroid injections (15mg vs 5mg dexamethasone) administered over 24 days. The trial also found increased likelihood of complete remission during 6-month follow-up in the group receiving repeat epidural dexamethasone, though this was low-quality evidence. Summary of Epidural and Paravertebral Injections Dr. Rosenblum summarizes that epidural or paravertebral injections of local anesthetic and/or glucocorticoids could be considered in treating acute herpes zoster-related pain. For subacute postherpetic neuralgia pain, he notes low-quality evidence supporting epidural injections, while for postherpetic neuralgia, evidence supports continuous epidural infusion, though also of low quality. Dr. Rosenblum emphasizes that none of the included studies for postherpetic neuralgia investigating epidural or paravertebral injections resulted in decreased pain compared to standard therapy. Pulsed Radiofrequency (PRF) Evidence Dr. Rosenblum discusses pulsed radiofrequency (PRF), noting that previous guidelines indicated moderate quality evidence that PRF of the intercostal nerve reduces pain for 6 months in patients with postherpetic neuralgia, and very low-quality evidence that PRF to the dorsal root ganglion (DRG) reduces pain for 6 months. He mentions that multiple studies have been published since then assessing PRF efficacy. PRF Studies for Acute Herpes Zoster Dr. Rosenblum discusses a randomized controlled trial with 60 patients comparing high-voltage bipolar PRF of the cervical sympathetic chain versus sham, with treatment repeated after three days in both groups. He reports that VAS scores in the PRF group at each post-interventional point (1 day, 2 days, 1 month, 2 months, 3 months) were significantly lower than in the sham group, and at 3 months, the incidence of postherpetic neuralgia was 16.7% in the PRF group compared to 40% in the sham group. PRF for Trigeminal Neuralgia Dr. Rosenblum cites another randomized controlled trial evaluating high-voltage long-duration PRF of the Gasserian ganglion in 96 patients with subacute herpes-related trigeminal neuralgia, which found decreased VAS pain scores at all post-interventional time points (3, 7, 14 days and 1, 3, and 6 months) compared to the sham group. He also mentions a randomized comparative effectiveness study in 120 patients with subacute trigeminal herpes zoster, comparing a single application of high-voltage PRF to the Gasserian ganglion versus three cycles of conventional PRF treatment, finding significantly lower mean VAS pain scores for up to six months in the high-voltage PRF group. PRF Compared to Other Interventions Dr. Rosenblum discusses a randomized controlled trial comparing PRF to short-term spinal cord stimulation, which found decreased pain and improved 36-item short-form health survey scores in both groups at six months. He also mentions a randomized controlled trial in 72 patients where PRF of spinal nerves or peripheral branches of cranial nerves combined with five-day infusion of IV lidocaine resulted in greater pain reduction, less rescue analgesia, and reduced inflammatory cytokines at two months compared to PRF with saline infusions. Dr. Rosenblum notes a major limitation of this study was not accounting for the high natural recovery rate. Summary of PRF and Final Recommendations Dr. Rosenblum summarizes that PRF provides significant pain relief lasting over three months in patients with subacute herpes zoster and postherpetic neuralgia. He notes that since few studies have compared PRF versus sham, it's not possible to calculate an accurate number needed to treat. Dr. Rosenblum mentions there are no comparative studies comparing PRF to the intercostal nerves versus PRF of the DRG, but both preclinical and clinical studies suggest superiority of the DRG approach. He adds that evidence for spinal cord stimulation for postherpetic neuralgia is of low quality, and more research is needed given its invasive nature. Sympathetic Blocks and Conclusion Dr. Rosenblum notes there is low-quality evidence for using sympathetic blocks to treat acute herpes zoster-related pain, but no evidence for their use in postherpetic neuralgia. He mentions that risks of treatment with intrathecal methylprednisolone are unclear and therefore not recommended. Dr. Rosenblum concludes by praising the comprehensive article he's been discussing and mentions it provides insight for treating his patients, including a recent case of trigeminal postherpetic neuralgia. Personal Clinical Approach and Closing Dr. Rosenblum shares that he doesn't currently perform PRF in his practice, partly because it's not standard of care and not well reimbursed, creating barriers to implementation. However, he notes that PRF is a very safe procedure as it doesn't involve burning tissue. For his patient with trigeminal neuralgia pain, Dr. Rosenblum plans to try a topical sphenopalatine ganglion block as the least invasive intervention before considering injecting the trigeminal nerves at the foramen, in addition to pharmacotherapy. He concludes by thanking listeners, encouraging them to check the show notes and links, mentioning institutional memberships and shadowing opportunities, and asking listeners to rate and share the podcast. Q&A No Q&A session in this lecture Pain Management Board Prep   Ultrasound Training REGISTER TODAY!   Create an Account and get Free Access to the PainExam- NRAP Academy Community Highlights     David Rosenblum, MD, currently serves as the Director of Pain Management at Maimonides Medical Center and AABP Integrative Pain Care.  As a member of the Department of Anesthesiology, he is involved in teaching, research, CME activities, and was key faculty in developing the anesthesiology residency's regional anesthesia block rotation, as well as institutional wide acute and chronic pain management protocols to ensure safe and effective pain management. He currently is a managing partner in a multi-physician private pain practice, AABP Integrative Pain Care, located in Brooklyn, NY. He is one of the earliest interventional pain physicians to integrate ultrasound guidance to improve the safety and accuracy of interventional pain procedures.   Awards New York Magazine: Top Doctors: 2016, 2017, 2018, 2021, 2022, 2023, 2024, 2025 Schneps Media: 2015, 2016, 2017, 2019, 2020 Top Doctors New York Metro Area (digital guide): 2016, 2017, 2018, 2019, 2020, 2021, 2022, 2023 2025 Schneps Media - Brooklyn Courier Life: 2021, 2022, 2023   Dr. Rosenblum written several book chapters on Peripheral Neuromodulation, Radiofrequency Ablation, and Pharmacology.  He has published numerous noteworthy articles and most recently is developing the ASIPP Guidelines for Peripheral Neuromodulation in the treatment of chronic pain. He has been named several times in NY Magazine's Best Pain Management Doctor List, Nassau County's Best Pain Physician, has appeared on NY1 News, and has made several appearances on XM Radio's Doctor Talk. He currently is lecturing on a national and international level and has partnered with the American Society of Interventional Pain Physicians (ASIPP), American Society of Pain and Neuroscience (ASPN), IASP Mexican Chapter, Eastern Pain Association (EPA), the North American Neuromodulation Society (NANS), World Academy of Pain Medicine United, as well as various other organizations, to support educational events and develop new courses. Since 2008, he has helped over 3000 physicians pass the Pain Management Boards, and has been at the forefront of utilizing ultrasound guidance to perform pain procedures.  He now hosts the PainExam podcast, AnesthesiaExam Podcast, PMRExam Podcasts and uses this platform to promote the safe and effective use of ultrasound in the performance of various procedures such as Peripheral Nerve Stimulation, Caudal Epidurals, Selective Nerve Root Blocks, Cluneal Nerve Blocks, Ganglion impar Blocks, Stellate Ganglion Blocks, Brachial Plexus Blocks, Joint Injections and much more!   Doctor Rosenblum created the NRAP (Neuromodulation Regional Anesthesia and Pain) Academy  and travels to teach various courses focused on Pain Medicine, Regenerative Medicine, Ultrasound Guided Pain Procedures and Regional Anesthesia Techniques.  Dr. Rosenblum is persistent when it comes to eliminating pain and has gained a reputation among his patients for thinking "outside the box" and implements ultrasound guidance to deposit medications, biologics (PRP, Bone Marrow Aspirate, etc.) and Peripheral Nerve Stimulators near pain generators. He is currently treating patients in his great neck and Brooklyn office.  For an appointment go to AABPpain.com or call Brooklyn     718 436 7246 Reference Adriaansen, E. J., Jacobs, J. G., Vernooij, L. M., van Wijck, A. J., Cohen, S. P., Huygen, F. J., & Rijsdijk, M. (2025). 8. Herpes zoster and post herpetic neuralgia. Pain Practice, 25(1), e13423.

Summary In this episode of the Pain Exam Podcast, Dr. David Rosenblum provides a comprehensive review of herpes zoster and postherpetic neuralgia (PHN), focusing on pathophysiology, diagnosis, and treatment options. Dr. Rosenblum explains that postherpetic neuralgia affects approximately 25% of patients with acute herpes zoster, causing debilitating unilateral chronic pain in one or more dermatomes. He discusses the three phases of herpes zoster: acute (up to 30 days), subacute (up to 3 months), and postherpetic neuralgia (pain continuing beyond 3 months). Dr. Rosenblum identifies risk factors for developing PHN, including older age, female sex, immunosuppression, prodromal pain, severe rash, and greater acute pain severity. He details the pathophysiology involving peripheral and central sensitization, and explains different phenotypes of PHN that can guide treatment approaches. For treatment, Dr. Rosenblum reviews various options including antiviral medications (which should be started within 72 hours of onset), corticosteroids, opioids, antidepressants (particularly tricyclics and SNRIs), antiepileptics (gabapentin and pregabalin), topical agents (lidocaine and capsaicin), and interventional procedures such as epidural injections and pulsed radiofrequency. He emphasizes that prevention through vaccination with Shingrix is highly effective, with 97% effectiveness in preventing herpes zoster in patients 50-69 years old and 89% effectiveness in those over 70. Dr. Rosenblum mentions that he's currently treating a patient with trigeminal postherpetic neuralgia and is considering a topical sphenopalatine ganglion block as a minimally invasive intervention before attempting more invasive procedures. Chapters Introduction to the Pain Exam Podcast and Topic Overview Dr. David Rosenblum introduces the Pain Exam Podcast, mentioning that it covers painful disorders, alternative treatments, and practice management. He explains that this episode focuses on herpes zoster and postherpetic neuralgia as board preparation for fellows starting their programs, with ABA boards coming up in September. Dr. Rosenblum notes that he's not only preparing listeners for boards but also seeking the latest information to help treat his own patients with this notoriously difficult disease. Upcoming Conferences and Educational Opportunities Dr. Rosenblum announces several upcoming conferences including Aspen in July, Pain Week in September, and events with NYSIP and the Latin American Pain Society. He mentions he'll be teaching ultrasound and regenerative medicine at these events. Dr. Rosenblum invites listeners to sign up at nrappain.org to access a community discussing regenerative medicine, ultrasound-guided pain medicine, regional anesthesia, and board preparation. He also offers ultrasound training in New York and elsewhere, with upcoming sessions in Manhattan on July 12th and October 4th, plus private shadowing opportunities. Overview of Postherpetic Neuralgia Dr. Rosenblum defines postherpetic neuralgia as typically a unilateral chronic pain in one or more dermatomes after acute herpes zoster infection. He states that the incidence of acute herpes zoster ranges between 3-5 patients per thousand person-years, and one in four patients with acute herpes zoster-related pain will transition into postherpetic neuralgia. Dr. Rosenblum emphasizes that while this condition won't kill patients, it can be extremely debilitating and significantly reduce quality of life. Treatment Options Overview Dr. Rosenblum reviews treatment options according to the WHO pain ladder, including tricyclics like nortriptyline and antiepileptic drugs such as gabapentin. He explains that if pain is not significantly reduced, interventional treatments like epidural injections with local anesthetics and corticosteroids or pulsed radiofrequency of the dorsal root ganglion are options. For postherpetic neuralgia specifically, Dr. Rosenblum notes that preferred treatments include transdermal capsaicin, lidocaine, or oral drugs such as antidepressants or antiepileptics. Phases of Herpes Zoster and Definitions Dr. Rosenblum outlines the three phases during herpes zoster reactivation: acute herpes zoster-related pain (lasting maximum 30 days), subacute herpes zoster-related pain (pain after healing of vesicles but disappearing within 3 months), and postherpetic neuralgia (typically defined as pain continuing after 3 months). He mentions that acute herpes zoster pain often begins with prodromal pain starting a few days before the appearance of the rash. Incidence and Risk Factors Dr. Rosenblum states that the incidence of herpes zoster ranges between 3-5 patients per 1,000 person-years, with approximately 5-30% of cases leading to postherpetic neuralgia. He identifies risk factors including older age, female sex, immunosuppression, prodromal pain, severe rash, and greater acute pain severity. Dr. Rosenblum describes the clinical manifestations as a mosaic of somatosensory symptoms including burning, deep aching pain, tingling, itching, stabbing, often associated with tactile and cold allodynia. Impact on Quality of Life Dr. Rosenblum emphasizes that postherpetic neuralgia can be debilitating, impacting both physical and emotional functioning and causing decreased quality of life. He notes that it leads to fatigue, insomnia, depression, anorexia, anxiety, and emotional distress. Dr. Rosenblum stresses the importance of exploring methods for prevention of postherpetic neuralgia and optimizing pain treatment for both subacute herpes zoster-related pain and postherpetic neuralgia. Literature Review and Pathophysiology Dr. Rosenblum mentions that he's discussing a literature review from 2024 that updates previous practical guidelines published in 2011. He explains the pathophysiology of postherpetic neuralgia, which involves sensitization of peripheral and sensory nerves from damage. Dr. Rosenblum describes how inflammatory mediators reduce the stimulus threshold of nociceptors and increase responsiveness, resulting in pathological spontaneous discharges, lower thresholds for thermal and mechanical stimuli, and hyperalgesia. Central Sensitization and Nerve Damage Dr. Rosenblum explains that central sensitization results from peripheral nociceptor hyperactivity leading to plastic changes in the central nervous system, involving amplification of pain signals and reduced inhibition. He describes how nerve damage in postherpetic neuralgia patients results from neuronal death due to severe inflammatory stimuli or secondary to neuronal swelling. Dr. Rosenblum notes that motor defects occur in 0.05% of patients with herpes zoster, observed as abdominal pseudohernias or motor weakness of limbs limited to the affected myotome. Different Phenotypes and Classification Dr. Rosenblum discusses different phenotypes of postherpetic neuralgia and how phenotyping can determine treatment. He explains that there are several ways to classify the phenotypes, with one categorizing patients into three subtypes: sensory loss (most common), thermal gain, and thermal loss with mechanical gain. Dr. Rosenblum describes the mechanistic categorization, including the irritable nociceptive phenotype characterized by preserved sensation, profound dynamic mechanical allodynia, reduced pressure pain threshold, and relief with local anesthetic infiltration. Deafferentation Phenotype Dr. Rosenblum explains that a deafferentation phenotype may arise from destruction of neurons by the virus in the dorsal root ganglion. This phenotype is characterized by sensory loss, including thermal and vibratory sensation without prominent thermal allodynia. He notes that mechanical allodynia can occur secondary to A-beta fibers activating spinothalamic pathways (known as phenotypic switches), along with pressure hyperalgesia and temporal summation suggesting central sensitization. Dr. Rosenblum mentions that in one study, this phenotype was present in 10.8% of individuals, and for those with deafferentation pain, gabapentinoids, antidepressants, and neuromodulatory therapies like repetitive transcranial magnetic stimulation may be beneficial. Diagnosis and Physical Examination Dr. Rosenblum discusses the diagnosis of herpes zoster and postherpetic neuralgia, emphasizing the importance of physical examination. He explains that diagnosis is based on the rash, redness, papules, and vesicles in the painful dermatomes, with healing vesicles showing crust formation. Dr. Rosenblum notes that the rash is generally unilateral and does not cross the midline of the body. In postherpetic neuralgia patients, he mentions that scarring, hyper or hypopigmentation is often visible, with allodynia present in 45-75% of affected patients. Sensory Testing and Assessment Dr. Rosenblum explains that in patients with postherpetic neuralgia, a mosaic of somatosensory alterations can occur, manifesting as hyperalgesia, allodynia, and sensory loss. These can be quantified by quantitative sensory testing, which assesses somatosensory functions, dermal detection thresholds for perception of cold, warmth, and paradoxical heat sensations. He notes that testing can provide clues regarding underlying mechanisms of pain, impaired conditioned pain modulation, temporal summation suggesting central sensitization, and information about the type of nerve damage and surviving afferent neurons. Prevention Through Vaccination Dr. Rosenblum discusses prevention of acute herpes zoster through vaccination, noting that the risk increases with reduced immunity. He highlights studies evaluating Shingrix, a vaccine for herpes zoster, which showed 97% effectiveness in preventing herpes zoster in patients 50-69 years old with healthy immune systems and 89% effectiveness in patients over 70. Dr. Rosenblum states that Shingrix is 89-91% effective in preventing postherpetic neuralgia development in patients with healthy immune systems and 68-91% effective in those with weakened or underlying conditions. Treatment Objectives Dr. Rosenblum outlines the treatment objectives for herpes zoster and postherpetic neuralgia. For acute herpes zoster, objectives include relieving pain, reducing severity and duration of pain, accelerating recovery of epidermal defects, and preventing secondary infections. For postherpetic neuralgia, the objectives are pain alleviation and improved quality of life. Dr. Rosenblum lists available treatments including psychotherapy, opiates, antidepressants, antiepileptics, NMDA antagonists, topical agents, and interventional treatments such as epidurals, pulsed radiofrequency, nerve blocks, and spinal cord stimulation. Antiviral Medications Dr. Rosenblum emphasizes that antiviral drugs should be started within 72 hours of clinical onset, mentioning famciclovir, valacyclovir, and acyclovir. He notes there is no evidence for effectiveness after 72 hours in patients with uncomplicated herpes zoster. Dr. Rosenblum provides dosing information: for immunocompetent patients, famciclovir 500mg and valacyclovir 1000mg three times daily for seven days; for immunocompromised patients, famciclovir 1000mg three times daily for 10 days, while acyclovir should be given IV in the immunocompromised. Benefits of Antiviral Therapy Dr. Rosenblum explains that antiviral medication accelerates the disappearance of vesicles and crusts, promotes healing of skin lesions, and prevents new lesions from forming. By inhibiting viral replication, he notes that antiviral therapy likely reduces nerve damage, resulting in reduced incidence of postherpetic neuralgia, and should be started as soon as possible. Corticosteroids and Opioids Dr. Rosenblum discusses the use of corticosteroids, noting that when added to antiviral medications, they may reduce the severity of acute herpes zoster-related pain, though increased healing of skin lesions was not observed in one study. He mentions that a Cochrane review found oral corticosteroids ineffective in preventing postherpetic neuralgia. Regarding opioids, Dr. Rosenblum states they are commonly used alongside antivirals for controlling acute herpes zoster pain, with tramadol having a number needed to treat (NNT) of 4.7 and strong opioids having an NNT of 4.3 for 50% pain reduction. Methadone and Antidepressants Dr. Rosenblum discusses methadone as an NMDA receptor antagonist used in acute and chronic pain management, though he notes there are no randomized controlled trials determining its efficacy in acute herpes zoster pain or postherpetic neuralgia. He explains that methadone can modulate pain stimuli by inhibiting the uptake of norepinephrine and serotonin, resulting in decreased development of hyperalgesia and opioid tolerance, but has side effects including constipation, nausea, sedation, and QT prolongation that can trigger torsades de pointes. Dr. Rosenblum identifies antidepressants as first-line therapy for postherpetic neuralgia, including tricyclics and SNRIs, with tricyclics having an NNT of 3 and SNRIs an NNT of 6.4 for 50% pain reduction. Antiepileptics and Pharmacological Treatment Summary Dr. Rosenblum discusses antiepileptics like gabapentin and pregabalin for postherpetic neuralgia. He cites two trials measuring gabapentin's effect, concluding it was effective compared to placebo with a pooled NNT of 4.4, while pregabalin had an NNT of 4.9. Dr. Rosenblum summarizes that pharmacological treatment is well established for subacute herpes zoster pain, though new high-quality evidence has been lacking since the last update in 2011. Topical Agents Dr. Rosenblum discusses local anesthetic topical agents including lidocaine and capsaicin creams and patches. He notes that 8% capsaicin provided significant pain reduction during 2-8 weeks, while 5% lidocaine patches provided moderate pain relief after eight weeks of treatment. Dr. Rosenblum also mentions acute herpes zoster intracutaneous injections, citing a study where single intracutaneous injection with methylprednisolone combined with ropivacaine versus saline alone showed significant difference in VAS score at 1 and 4 weeks post-intervention favoring the intervention group. Intracutaneous Injections Dr. Rosenblum discusses the effect of repetitive intracutaneous injections with ropivacaine and methylprednisolone every 48 hours for one week. He cites a randomized control trial comparing antivirals plus analgesics to antivirals plus analgesics and repeat injections, finding the intervention group had significantly shorter duration of pain, lower VAS scores, and lower incidence of postherpetic neuralgia (6.4% vs 28% at 3 months). Dr. Rosenblum notes that a potential side effect of cutaneous methylprednisolone injection is fat atrophy, though this wasn't reported in the study. Summary of Local Anesthetics Dr. Rosenblum summarizes that there are no new studies reporting the efficacy of capsaicin 8% for postherpetic neuralgia, but it remains widely used in clinical practice and is approved in several countries. He notes that lidocaine patches can reduce pain intensity in patients with postherpetic neuralgia but may be more beneficial in patients with allodynia. Dr. Rosenblum adds that intracutaneous injections may be helpful for short periods, while repetitive injections with local anesthetics may reduce VAS scores for up to six months but can cause subcutaneous fat atrophy. Interventional Treatments: Epidural and Paravertebral Injections Dr. Rosenblum discusses interventional treatments, noting that previous guidelines found epidural injection with corticosteroids and local anesthetic as add-on therapy superior to standard care alone for up to one month in managing acute herpes zoster pain. He mentions a randomized controlled trial showing no difference between interlaminar and transforaminal epidural steroid injections for up to three months after the procedure. Dr. Rosenblum adds that previous guidelines reported high-quality evidence that paravertebral injections of corticosteroids or local anesthetic reduces pain in the active phase of herpes zoster. Comparative Studies on Injection Approaches Dr. Rosenblum discusses a trial comparing efficacy of repetitive paravertebral blocks with ropivacaine versus dexmedetomidine to prevent postherpetic neuralgia, which showed significantly lower incidence of zoster-related pain one month after therapy in the dexmedetomidine group, with effects still significant at three months. He also mentions a study comparing steroid injections administered via interlaminar versus transforaminal approaches, finding both groups had significantly lower VAS scores at 1 and 3 months follow-up compared to baseline, though this could align with the natural course of herpes zoster. Timing of Interventions and Continuous Epidural Blockade Dr. Rosenblum cites a retrospective study showing that transforaminal epidural injections administered for acute herpes zoster-related pain were associated with significantly shorter time to pain relief compared to those performed in the subacute phase. He also mentions a randomized controlled trial finding that continuous epidural blockade combined with opioids and gabapentin reduced NRS pain scores more than analgesic drug treatments alone during three-day follow-up, though both studies were low-quality. Interventions for Postherpetic Neuralgia Dr. Rosenblum discusses interventions specifically for postherpetic neuralgia, citing a small randomized controlled trial that demonstrated decreased NRS pain scores six months post-treatment for repeat versus single epidural steroid injections (15mg vs 5mg dexamethasone) administered over 24 days. The trial also found increased likelihood of complete remission during 6-month follow-up in the group receiving repeat epidural dexamethasone, though this was low-quality evidence. Summary of Epidural and Paravertebral Injections Dr. Rosenblum summarizes that epidural or paravertebral injections of local anesthetic and/or glucocorticoids could be considered in treating acute herpes zoster-related pain. For subacute postherpetic neuralgia pain, he notes low-quality evidence supporting epidural injections, while for postherpetic neuralgia, evidence supports continuous epidural infusion, though also of low quality. Dr. Rosenblum emphasizes that none of the included studies for postherpetic neuralgia investigating epidural or paravertebral injections resulted in decreased pain compared to standard therapy. Pulsed Radiofrequency (PRF) Evidence Dr. Rosenblum discusses pulsed radiofrequency (PRF), noting that previous guidelines indicated moderate quality evidence that PRF of the intercostal nerve reduces pain for 6 months in patients with postherpetic neuralgia, and very low-quality evidence that PRF to the dorsal root ganglion (DRG) reduces pain for 6 months. He mentions that multiple studies have been published since then assessing PRF efficacy. PRF Studies for Acute Herpes Zoster Dr. Rosenblum discusses a randomized controlled trial with 60 patients comparing high-voltage bipolar PRF of the cervical sympathetic chain versus sham, with treatment repeated after three days in both groups. He reports that VAS scores in the PRF group at each post-interventional point (1 day, 2 days, 1 month, 2 months, 3 months) were significantly lower than in the sham group, and at 3 months, the incidence of postherpetic neuralgia was 16.7% in the PRF group compared to 40% in the sham group. PRF for Trigeminal Neuralgia Dr. Rosenblum cites another randomized controlled trial evaluating high-voltage long-duration PRF of the Gasserian ganglion in 96 patients with subacute herpes-related trigeminal neuralgia, which found decreased VAS pain scores at all post-interventional time points (3, 7, 14 days and 1, 3, and 6 months) compared to the sham group. He also mentions a randomized comparative effectiveness study in 120 patients with subacute trigeminal herpes zoster, comparing a single application of high-voltage PRF to the Gasserian ganglion versus three cycles of conventional PRF treatment, finding significantly lower mean VAS pain scores for up to six months in the high-voltage PRF group. PRF Compared to Other Interventions Dr. Rosenblum discusses a randomized controlled trial comparing PRF to short-term spinal cord stimulation, which found decreased pain and improved 36-item short-form health survey scores in both groups at six months. He also mentions a randomized controlled trial in 72 patients where PRF of spinal nerves or peripheral branches of cranial nerves combined with five-day infusion of IV lidocaine resulted in greater pain reduction, less rescue analgesia, and reduced inflammatory cytokines at two months compared to PRF with saline infusions. Dr. Rosenblum notes a major limitation of this study was not accounting for the high natural recovery rate. Summary of PRF and Final Recommendations Dr. Rosenblum summarizes that PRF provides significant pain relief lasting over three months in patients with subacute herpes zoster and postherpetic neuralgia. He notes that since few studies have compared PRF versus sham, it's not possible to calculate an accurate number needed to treat. Dr. Rosenblum mentions there are no comparative studies comparing PRF to the intercostal nerves versus PRF of the DRG, but both preclinical and clinical studies suggest superiority of the DRG approach. He adds that evidence for spinal cord stimulation for postherpetic neuralgia is of low quality, and more research is needed given its invasive nature. Sympathetic Blocks and Conclusion Dr. Rosenblum notes there is low-quality evidence for using sympathetic blocks to treat acute herpes zoster-related pain, but no evidence for their use in postherpetic neuralgia. He mentions that risks of treatment with intrathecal methylprednisolone are unclear and therefore not recommended. Dr. Rosenblum concludes by praising the comprehensive article he's been discussing and mentions it provides insight for treating his patients, including a recent case of trigeminal postherpetic neuralgia. Personal Clinical Approach and Closing Dr. Rosenblum shares that he doesn't currently perform PRF in his practice, partly because it's not standard of care and not well reimbursed, creating barriers to implementation. However, he notes that PRF is a very safe procedure as it doesn't involve burning tissue. For his patient with trigeminal neuralgia pain, Dr. Rosenblum plans to try a topical sphenopalatine ganglion block as the least invasive intervention before considering injecting the trigeminal nerves at the foramen, in addition to pharmacotherapy. He concludes by thanking listeners, encouraging them to check the show notes and links, mentioning institutional memberships and shadowing opportunities, and asking listeners to rate and share the podcast. Q&A No Q&A session in this lecture Pain Management Board Prep   Ultrasound Training REGISTER TODAY!   Create an Account and get Free Access to the PainExam- NRAP Academy Community Highlights     David Rosenblum, MD, currently serves as the Director of Pain Management at Maimonides Medical Center and AABP Integrative Pain Care.  As a member of the Department of Anesthesiology, he is involved in teaching, research, CME activities, and was key faculty in developing the anesthesiology residency's regional anesthesia block rotation, as well as institutional wide acute and chronic pain management protocols to ensure safe and effective pain management. He currently is a managing partner in a multi-physician private pain practice, AABP Integrative Pain Care, located in Brooklyn, NY. He is one of the earliest interventional pain physicians to integrate ultrasound guidance to improve the safety and accuracy of interventional pain procedures.   Awards New York Magazine: Top Doctors: 2016, 2017, 2018, 2021, 2022, 2023, 2024, 2025 Schneps Media: 2015, 2016, 2017, 2019, 2020 Top Doctors New York Metro Area (digital guide): 2016, 2017, 2018, 2019, 2020, 2021, 2022, 2023 2025 Schneps Media - Brooklyn Courier Life: 2021, 2022, 2023   Dr. Rosenblum written several book chapters on Peripheral Neuromodulation, Radiofrequency Ablation, and Pharmacology.  He has published numerous noteworthy articles and most recently is developing the ASIPP Guidelines for Peripheral Neuromodulation in the treatment of chronic pain. He has been named several times in NY Magazine's Best Pain Management Doctor List, Nassau County's Best Pain Physician, has appeared on NY1 News, and has made several appearances on XM Radio's Doctor Talk. He currently is lecturing on a national and international level and has partnered with the American Society of Interventional Pain Physicians (ASIPP), American Society of Pain and Neuroscience (ASPN), IASP Mexican Chapter, Eastern Pain Association (EPA), the North American Neuromodulation Society (NANS), World Academy of Pain Medicine United, as well as various other organizations, to support educational events and develop new courses. Since 2008, he has helped over 3000 physicians pass the Pain Management Boards, and has been at the forefront of utilizing ultrasound guidance to perform pain procedures.  He now hosts the PainExam podcast, AnesthesiaExam Podcast, PMRExam Podcasts and uses this platform to promote the safe and effective use of ultrasound in the performance of various procedures such as Peripheral Nerve Stimulation, Caudal Epidurals, Selective Nerve Root Blocks, Cluneal Nerve Blocks, Ganglion impar Blocks, Stellate Ganglion Blocks, Brachial Plexus Blocks, Joint Injections and much more!   Doctor Rosenblum created the NRAP (Neuromodulation Regional Anesthesia and Pain) Academy  and travels to teach various courses focused on Pain Medicine, Regenerative Medicine, Ultrasound Guided Pain Procedures and Regional Anesthesia Techniques.  Dr. Rosenblum is persistent when it comes to eliminating pain and has gained a reputation among his patients for thinking "outside the box" and implements ultrasound guidance to deposit medications, biologics (PRP, Bone Marrow Aspirate, etc.) and Peripheral Nerve Stimulators near pain generators. He is currently treating patients in his great neck and Brooklyn office.  For an appointment go to AABPpain.com or call Brooklyn     718 436 7246 Reference Adriaansen, E. J., Jacobs, J. G., Vernooij, L. M., van Wijck, A. J., Cohen, S. P., Huygen, F. J., & Rijsdijk, M. (2025). 8. Herpes zoster and post herpetic neuralgia. Pain Practice, 25(1), e13423.

Summary In this episode of the Pain Exam Podcast, Dr. David Rosenblum provides a comprehensive review of herpes zoster and postherpetic neuralgia (PHN), focusing on pathophysiology, diagnosis, and treatment options. Dr. Rosenblum explains that postherpetic neuralgia affects approximately 25% of patients with acute herpes zoster, causing debilitating unilateral chronic pain in one or more dermatomes. He discusses the three phases of herpes zoster: acute (up to 30 days), subacute (up to 3 months), and postherpetic neuralgia (pain continuing beyond 3 months). Dr. Rosenblum identifies risk factors for developing PHN, including older age, female sex, immunosuppression, prodromal pain, severe rash, and greater acute pain severity. He details the pathophysiology involving peripheral and central sensitization, and explains different phenotypes of PHN that can guide treatment approaches. For treatment, Dr. Rosenblum reviews various options including antiviral medications (which should be started within 72 hours of onset), corticosteroids, opioids, antidepressants (particularly tricyclics and SNRIs), antiepileptics (gabapentin and pregabalin), topical agents (lidocaine and capsaicin), and interventional procedures such as epidural injections and pulsed radiofrequency. He emphasizes that prevention through vaccination with Shingrix is highly effective, with 97% effectiveness in preventing herpes zoster in patients 50-69 years old and 89% effectiveness in those over 70. Dr. Rosenblum mentions that he's currently treating a patient with trigeminal postherpetic neuralgia and is considering a topical sphenopalatine ganglion block as a minimally invasive intervention before attempting more invasive procedures. Chapters Introduction to the Pain Exam Podcast and Topic Overview Dr. David Rosenblum introduces the Pain Exam Podcast, mentioning that it covers painful disorders, alternative treatments, and practice management. He explains that this episode focuses on herpes zoster and postherpetic neuralgia as board preparation for fellows starting their programs, with ABA boards coming up in September. Dr. Rosenblum notes that he's not only preparing listeners for boards but also seeking the latest information to help treat his own patients with this notoriously difficult disease. Upcoming Conferences and Educational Opportunities Dr. Rosenblum announces several upcoming conferences including Aspen in July, Pain Week in September, and events with NYSIP and the Latin American Pain Society. He mentions he'll be teaching ultrasound and regenerative medicine at these events. Dr. Rosenblum invites listeners to sign up at nrappain.org to access a community discussing regenerative medicine, ultrasound-guided pain medicine, regional anesthesia, and board preparation. He also offers ultrasound training in New York and elsewhere, with upcoming sessions in Manhattan on July 12th and October 4th, plus private shadowing opportunities. Overview of Postherpetic Neuralgia Dr. Rosenblum defines postherpetic neuralgia as typically a unilateral chronic pain in one or more dermatomes after acute herpes zoster infection. He states that the incidence of acute herpes zoster ranges between 3-5 patients per thousand person-years, and one in four patients with acute herpes zoster-related pain will transition into postherpetic neuralgia. Dr. Rosenblum emphasizes that while this condition won't kill patients, it can be extremely debilitating and significantly reduce quality of life. Treatment Options Overview Dr. Rosenblum reviews treatment options according to the WHO pain ladder, including tricyclics like nortriptyline and antiepileptic drugs such as gabapentin. He explains that if pain is not significantly reduced, interventional treatments like epidural injections with local anesthetics and corticosteroids or pulsed radiofrequency of the dorsal root ganglion are options. For postherpetic neuralgia specifically, Dr. Rosenblum notes that preferred treatments include transdermal capsaicin, lidocaine, or oral drugs such as antidepressants or antiepileptics. Phases of Herpes Zoster and Definitions Dr. Rosenblum outlines the three phases during herpes zoster reactivation: acute herpes zoster-related pain (lasting maximum 30 days), subacute herpes zoster-related pain (pain after healing of vesicles but disappearing within 3 months), and postherpetic neuralgia (typically defined as pain continuing after 3 months). He mentions that acute herpes zoster pain often begins with prodromal pain starting a few days before the appearance of the rash. Incidence and Risk Factors Dr. Rosenblum states that the incidence of herpes zoster ranges between 3-5 patients per 1,000 person-years, with approximately 5-30% of cases leading to postherpetic neuralgia. He identifies risk factors including older age, female sex, immunosuppression, prodromal pain, severe rash, and greater acute pain severity. Dr. Rosenblum describes the clinical manifestations as a mosaic of somatosensory symptoms including burning, deep aching pain, tingling, itching, stabbing, often associated with tactile and cold allodynia. Impact on Quality of Life Dr. Rosenblum emphasizes that postherpetic neuralgia can be debilitating, impacting both physical and emotional functioning and causing decreased quality of life. He notes that it leads to fatigue, insomnia, depression, anorexia, anxiety, and emotional distress. Dr. Rosenblum stresses the importance of exploring methods for prevention of postherpetic neuralgia and optimizing pain treatment for both subacute herpes zoster-related pain and postherpetic neuralgia. Literature Review and Pathophysiology Dr. Rosenblum mentions that he's discussing a literature review from 2024 that updates previous practical guidelines published in 2011. He explains the pathophysiology of postherpetic neuralgia, which involves sensitization of peripheral and sensory nerves from damage. Dr. Rosenblum describes how inflammatory mediators reduce the stimulus threshold of nociceptors and increase responsiveness, resulting in pathological spontaneous discharges, lower thresholds for thermal and mechanical stimuli, and hyperalgesia. Central Sensitization and Nerve Damage Dr. Rosenblum explains that central sensitization results from peripheral nociceptor hyperactivity leading to plastic changes in the central nervous system, involving amplification of pain signals and reduced inhibition. He describes how nerve damage in postherpetic neuralgia patients results from neuronal death due to severe inflammatory stimuli or secondary to neuronal swelling. Dr. Rosenblum notes that motor defects occur in 0.05% of patients with herpes zoster, observed as abdominal pseudohernias or motor weakness of limbs limited to the affected myotome. Different Phenotypes and Classification Dr. Rosenblum discusses different phenotypes of postherpetic neuralgia and how phenotyping can determine treatment. He explains that there are several ways to classify the phenotypes, with one categorizing patients into three subtypes: sensory loss (most common), thermal gain, and thermal loss with mechanical gain. Dr. Rosenblum describes the mechanistic categorization, including the irritable nociceptive phenotype characterized by preserved sensation, profound dynamic mechanical allodynia, reduced pressure pain threshold, and relief with local anesthetic infiltration. Deafferentation Phenotype Dr. Rosenblum explains that a deafferentation phenotype may arise from destruction of neurons by the virus in the dorsal root ganglion. This phenotype is characterized by sensory loss, including thermal and vibratory sensation without prominent thermal allodynia. He notes that mechanical allodynia can occur secondary to A-beta fibers activating spinothalamic pathways (known as phenotypic switches), along with pressure hyperalgesia and temporal summation suggesting central sensitization. Dr. Rosenblum mentions that in one study, this phenotype was present in 10.8% of individuals, and for those with deafferentation pain, gabapentinoids, antidepressants, and neuromodulatory therapies like repetitive transcranial magnetic stimulation may be beneficial. Diagnosis and Physical Examination Dr. Rosenblum discusses the diagnosis of herpes zoster and postherpetic neuralgia, emphasizing the importance of physical examination. He explains that diagnosis is based on the rash, redness, papules, and vesicles in the painful dermatomes, with healing vesicles showing crust formation. Dr. Rosenblum notes that the rash is generally unilateral and does not cross the midline of the body. In postherpetic neuralgia patients, he mentions that scarring, hyper or hypopigmentation is often visible, with allodynia present in 45-75% of affected patients. Sensory Testing and Assessment Dr. Rosenblum explains that in patients with postherpetic neuralgia, a mosaic of somatosensory alterations can occur, manifesting as hyperalgesia, allodynia, and sensory loss. These can be quantified by quantitative sensory testing, which assesses somatosensory functions, dermal detection thresholds for perception of cold, warmth, and paradoxical heat sensations. He notes that testing can provide clues regarding underlying mechanisms of pain, impaired conditioned pain modulation, temporal summation suggesting central sensitization, and information about the type of nerve damage and surviving afferent neurons. Prevention Through Vaccination Dr. Rosenblum discusses prevention of acute herpes zoster through vaccination, noting that the risk increases with reduced immunity. He highlights studies evaluating Shingrix, a vaccine for herpes zoster, which showed 97% effectiveness in preventing herpes zoster in patients 50-69 years old with healthy immune systems and 89% effectiveness in patients over 70. Dr. Rosenblum states that Shingrix is 89-91% effective in preventing postherpetic neuralgia development in patients with healthy immune systems and 68-91% effective in those with weakened or underlying conditions. Treatment Objectives Dr. Rosenblum outlines the treatment objectives for herpes zoster and postherpetic neuralgia. For acute herpes zoster, objectives include relieving pain, reducing severity and duration of pain, accelerating recovery of epidermal defects, and preventing secondary infections. For postherpetic neuralgia, the objectives are pain alleviation and improved quality of life. Dr. Rosenblum lists available treatments including psychotherapy, opiates, antidepressants, antiepileptics, NMDA antagonists, topical agents, and interventional treatments such as epidurals, pulsed radiofrequency, nerve blocks, and spinal cord stimulation. Antiviral Medications Dr. Rosenblum emphasizes that antiviral drugs should be started within 72 hours of clinical onset, mentioning famciclovir, valacyclovir, and acyclovir. He notes there is no evidence for effectiveness after 72 hours in patients with uncomplicated herpes zoster. Dr. Rosenblum provides dosing information: for immunocompetent patients, famciclovir 500mg and valacyclovir 1000mg three times daily for seven days; for immunocompromised patients, famciclovir 1000mg three times daily for 10 days, while acyclovir should be given IV in the immunocompromised. Benefits of Antiviral Therapy Dr. Rosenblum explains that antiviral medication accelerates the disappearance of vesicles and crusts, promotes healing of skin lesions, and prevents new lesions from forming. By inhibiting viral replication, he notes that antiviral therapy likely reduces nerve damage, resulting in reduced incidence of postherpetic neuralgia, and should be started as soon as possible. Corticosteroids and Opioids Dr. Rosenblum discusses the use of corticosteroids, noting that when added to antiviral medications, they may reduce the severity of acute herpes zoster-related pain, though increased healing of skin lesions was not observed in one study. He mentions that a Cochrane review found oral corticosteroids ineffective in preventing postherpetic neuralgia. Regarding opioids, Dr. Rosenblum states they are commonly used alongside antivirals for controlling acute herpes zoster pain, with tramadol having a number needed to treat (NNT) of 4.7 and strong opioids having an NNT of 4.3 for 50% pain reduction. Methadone and Antidepressants Dr. Rosenblum discusses methadone as an NMDA receptor antagonist used in acute and chronic pain management, though he notes there are no randomized controlled trials determining its efficacy in acute herpes zoster pain or postherpetic neuralgia. He explains that methadone can modulate pain stimuli by inhibiting the uptake of norepinephrine and serotonin, resulting in decreased development of hyperalgesia and opioid tolerance, but has side effects including constipation, nausea, sedation, and QT prolongation that can trigger torsades de pointes. Dr. Rosenblum identifies antidepressants as first-line therapy for postherpetic neuralgia, including tricyclics and SNRIs, with tricyclics having an NNT of 3 and SNRIs an NNT of 6.4 for 50% pain reduction. Antiepileptics and Pharmacological Treatment Summary Dr. Rosenblum discusses antiepileptics like gabapentin and pregabalin for postherpetic neuralgia. He cites two trials measuring gabapentin's effect, concluding it was effective compared to placebo with a pooled NNT of 4.4, while pregabalin had an NNT of 4.9. Dr. Rosenblum summarizes that pharmacological treatment is well established for subacute herpes zoster pain, though new high-quality evidence has been lacking since the last update in 2011. Topical Agents Dr. Rosenblum discusses local anesthetic topical agents including lidocaine and capsaicin creams and patches. He notes that 8% capsaicin provided significant pain reduction during 2-8 weeks, while 5% lidocaine patches provided moderate pain relief after eight weeks of treatment. Dr. Rosenblum also mentions acute herpes zoster intracutaneous injections, citing a study where single intracutaneous injection with methylprednisolone combined with ropivacaine versus saline alone showed significant difference in VAS score at 1 and 4 weeks post-intervention favoring the intervention group. Intracutaneous Injections Dr. Rosenblum discusses the effect of repetitive intracutaneous injections with ropivacaine and methylprednisolone every 48 hours for one week. He cites a randomized control trial comparing antivirals plus analgesics to antivirals plus analgesics and repeat injections, finding the intervention group had significantly shorter duration of pain, lower VAS scores, and lower incidence of postherpetic neuralgia (6.4% vs 28% at 3 months). Dr. Rosenblum notes that a potential side effect of cutaneous methylprednisolone injection is fat atrophy, though this wasn't reported in the study. Summary of Local Anesthetics Dr. Rosenblum summarizes that there are no new studies reporting the efficacy of capsaicin 8% for postherpetic neuralgia, but it remains widely used in clinical practice and is approved in several countries. He notes that lidocaine patches can reduce pain intensity in patients with postherpetic neuralgia but may be more beneficial in patients with allodynia. Dr. Rosenblum adds that intracutaneous injections may be helpful for short periods, while repetitive injections with local anesthetics may reduce VAS scores for up to six months but can cause subcutaneous fat atrophy. Interventional Treatments: Epidural and Paravertebral Injections Dr. Rosenblum discusses interventional treatments, noting that previous guidelines found epidural injection with corticosteroids and local anesthetic as add-on therapy superior to standard care alone for up to one month in managing acute herpes zoster pain. He mentions a randomized controlled trial showing no difference between interlaminar and transforaminal epidural steroid injections for up to three months after the procedure. Dr. Rosenblum adds that previous guidelines reported high-quality evidence that paravertebral injections of corticosteroids or local anesthetic reduces pain in the active phase of herpes zoster. Comparative Studies on Injection Approaches Dr. Rosenblum discusses a trial comparing efficacy of repetitive paravertebral blocks with ropivacaine versus dexmedetomidine to prevent postherpetic neuralgia, which showed significantly lower incidence of zoster-related pain one month after therapy in the dexmedetomidine group, with effects still significant at three months. He also mentions a study comparing steroid injections administered via interlaminar versus transforaminal approaches, finding both groups had significantly lower VAS scores at 1 and 3 months follow-up compared to baseline, though this could align with the natural course of herpes zoster. Timing of Interventions and Continuous Epidural Blockade Dr. Rosenblum cites a retrospective study showing that transforaminal epidural injections administered for acute herpes zoster-related pain were associated with significantly shorter time to pain relief compared to those performed in the subacute phase. He also mentions a randomized controlled trial finding that continuous epidural blockade combined with opioids and gabapentin reduced NRS pain scores more than analgesic drug treatments alone during three-day follow-up, though both studies were low-quality. Interventions for Postherpetic Neuralgia Dr. Rosenblum discusses interventions specifically for postherpetic neuralgia, citing a small randomized controlled trial that demonstrated decreased NRS pain scores six months post-treatment for repeat versus single epidural steroid injections (15mg vs 5mg dexamethasone) administered over 24 days. The trial also found increased likelihood of complete remission during 6-month follow-up in the group receiving repeat epidural dexamethasone, though this was low-quality evidence. Summary of Epidural and Paravertebral Injections Dr. Rosenblum summarizes that epidural or paravertebral injections of local anesthetic and/or glucocorticoids could be considered in treating acute herpes zoster-related pain. For subacute postherpetic neuralgia pain, he notes low-quality evidence supporting epidural injections, while for postherpetic neuralgia, evidence supports continuous epidural infusion, though also of low quality. Dr. Rosenblum emphasizes that none of the included studies for postherpetic neuralgia investigating epidural or paravertebral injections resulted in decreased pain compared to standard therapy. Pulsed Radiofrequency (PRF) Evidence Dr. Rosenblum discusses pulsed radiofrequency (PRF), noting that previous guidelines indicated moderate quality evidence that PRF of the intercostal nerve reduces pain for 6 months in patients with postherpetic neuralgia, and very low-quality evidence that PRF to the dorsal root ganglion (DRG) reduces pain for 6 months. He mentions that multiple studies have been published since then assessing PRF efficacy. PRF Studies for Acute Herpes Zoster Dr. Rosenblum discusses a randomized controlled trial with 60 patients comparing high-voltage bipolar PRF of the cervical sympathetic chain versus sham, with treatment repeated after three days in both groups. He reports that VAS scores in the PRF group at each post-interventional point (1 day, 2 days, 1 month, 2 months, 3 months) were significantly lower than in the sham group, and at 3 months, the incidence of postherpetic neuralgia was 16.7% in the PRF group compared to 40% in the sham group. PRF for Trigeminal Neuralgia Dr. Rosenblum cites another randomized controlled trial evaluating high-voltage long-duration PRF of the Gasserian ganglion in 96 patients with subacute herpes-related trigeminal neuralgia, which found decreased VAS pain scores at all post-interventional time points (3, 7, 14 days and 1, 3, and 6 months) compared to the sham group. He also mentions a randomized comparative effectiveness study in 120 patients with subacute trigeminal herpes zoster, comparing a single application of high-voltage PRF to the Gasserian ganglion versus three cycles of conventional PRF treatment, finding significantly lower mean VAS pain scores for up to six months in the high-voltage PRF group. PRF Compared to Other Interventions Dr. Rosenblum discusses a randomized controlled trial comparing PRF to short-term spinal cord stimulation, which found decreased pain and improved 36-item short-form health survey scores in both groups at six months. He also mentions a randomized controlled trial in 72 patients where PRF of spinal nerves or peripheral branches of cranial nerves combined with five-day infusion of IV lidocaine resulted in greater pain reduction, less rescue analgesia, and reduced inflammatory cytokines at two months compared to PRF with saline infusions. Dr. Rosenblum notes a major limitation of this study was not accounting for the high natural recovery rate. Summary of PRF and Final Recommendations Dr. Rosenblum summarizes that PRF provides significant pain relief lasting over three months in patients with subacute herpes zoster and postherpetic neuralgia. He notes that since few studies have compared PRF versus sham, it's not possible to calculate an accurate number needed to treat. Dr. Rosenblum mentions there are no comparative studies comparing PRF to the intercostal nerves versus PRF of the DRG, but both preclinical and clinical studies suggest superiority of the DRG approach. He adds that evidence for spinal cord stimulation for postherpetic neuralgia is of low quality, and more research is needed given its invasive nature. Sympathetic Blocks and Conclusion Dr. Rosenblum notes there is low-quality evidence for using sympathetic blocks to treat acute herpes zoster-related pain, but no evidence for their use in postherpetic neuralgia. He mentions that risks of treatment with intrathecal methylprednisolone are unclear and therefore not recommended. Dr. Rosenblum concludes by praising the comprehensive article he's been discussing and mentions it provides insight for treating his patients, including a recent case of trigeminal postherpetic neuralgia. Personal Clinical Approach and Closing Dr. Rosenblum shares that he doesn't currently perform PRF in his practice, partly because it's not standard of care and not well reimbursed, creating barriers to implementation. However, he notes that PRF is a very safe procedure as it doesn't involve burning tissue. For his patient with trigeminal neuralgia pain, Dr. Rosenblum plans to try a topical sphenopalatine ganglion block as the least invasive intervention before considering injecting the trigeminal nerves at the foramen, in addition to pharmacotherapy. He concludes by thanking listeners, encouraging them to check the show notes and links, mentioning institutional memberships and shadowing opportunities, and asking listeners to rate and share the podcast. Q&A No Q&A session in this lecture Pain Management Board Prep   Ultrasound Training REGISTER TODAY!   Create an Account and get Free Access to the PainExam- NRAP Academy Community Highlights     David Rosenblum, MD, currently serves as the Director of Pain Management at Maimonides Medical Center and AABP Integrative Pain Care.  As a member of the Department of Anesthesiology, he is involved in teaching, research, CME activities, and was key faculty in developing the anesthesiology residency's regional anesthesia block rotation, as well as institutional wide acute and chronic pain management protocols to ensure safe and effective pain management. He currently is a managing partner in a multi-physician private pain practice, AABP Integrative Pain Care, located in Brooklyn, NY. He is one of the earliest interventional pain physicians to integrate ultrasound guidance to improve the safety and accuracy of interventional pain procedures.   Awards New York Magazine: Top Doctors: 2016, 2017, 2018, 2021, 2022, 2023, 2024, 2025 Schneps Media: 2015, 2016, 2017, 2019, 2020 Top Doctors New York Metro Area (digital guide): 2016, 2017, 2018, 2019, 2020, 2021, 2022, 2023 2025 Schneps Media - Brooklyn Courier Life: 2021, 2022, 2023   Dr. Rosenblum written several book chapters on Peripheral Neuromodulation, Radiofrequency Ablation, and Pharmacology.  He has published numerous noteworthy articles and most recently is developing the ASIPP Guidelines for Peripheral Neuromodulation in the treatment of chronic pain. He has been named several times in NY Magazine's Best Pain Management Doctor List, Nassau County's Best Pain Physician, has appeared on NY1 News, and has made several appearances on XM Radio's Doctor Talk. He currently is lecturing on a national and international level and has partnered with the American Society of Interventional Pain Physicians (ASIPP), American Society of Pain and Neuroscience (ASPN), IASP Mexican Chapter, Eastern Pain Association (EPA), the North American Neuromodulation Society (NANS), World Academy of Pain Medicine United, as well as various other organizations, to support educational events and develop new courses. Since 2008, he has helped over 3000 physicians pass the Pain Management Boards, and has been at the forefront of utilizing ultrasound guidance to perform pain procedures.  He now hosts the PainExam podcast, AnesthesiaExam Podcast, PMRExam Podcasts and uses this platform to promote the safe and effective use of ultrasound in the performance of various procedures such as Peripheral Nerve Stimulation, Caudal Epidurals, Selective Nerve Root Blocks, Cluneal Nerve Blocks, Ganglion impar Blocks, Stellate Ganglion Blocks, Brachial Plexus Blocks, Joint Injections and much more!   Doctor Rosenblum created the NRAP (Neuromodulation Regional Anesthesia and Pain) Academy  and travels to teach various courses focused on Pain Medicine, Regenerative Medicine, Ultrasound Guided Pain Procedures and Regional Anesthesia Techniques.  Dr. Rosenblum is persistent when it comes to eliminating pain and has gained a reputation among his patients for thinking "outside the box" and implements ultrasound guidance to deposit medications, biologics (PRP, Bone Marrow Aspirate, etc.) and Peripheral Nerve Stimulators near pain generators. He is currently treating patients in his great neck and Brooklyn office.  For an appointment go to AABPpain.com or call Brooklyn     718 436 7246 Reference Adriaansen, E. J., Jacobs, J. G., Vernooij, L. M., van Wijck, A. J., Cohen, S. P., Huygen, F. J., & Rijsdijk, M. (2025). 8. Herpes zoster and post herpetic neuralgia. Pain Practice, 25(1), e13423.

The Lord's Own Prayer, Part 2 - Dan Cochrane

Colleagues Chris Lafakis and Steve Cochrane join Inside Economics to discuss how geopolitics is shaping the outlook and the risks to the U.S. and global economies. But first, the team reminisces about Steve's 32 years as “employee 007” at the company and his upcoming retirement. Steve reveals his secrets for “managing up,” and Mark finds out he's been managed all these years. The conversation then turns to U.S.-China relations and the risk of an oil price shock stemming from Israel's attack on Iran last week.  Guest: Chris Lafakis, Director of Climate and Energy Economics, Moody's Analytics, Steve Cochrane, Director, Chief APAC EconomistHosts: Mark Zandi – Chief Economist, Moody's Analytics, Cris deRitis – Deputy Chief Economist, Moody's Analytics, and Marisa DiNatale – Senior Director - Head of Global Forecasting, Moody's AnalyticsFollow Mark Zandi on 'X' and BlueSky @MarkZandi, Cris deRitis on LinkedIn, and Marisa DiNatale on LinkedIn Questions or Comments, please email us at helpeconomy@moodys.com. We would love to hear from you. To stay informed and follow the insights of Moody's Analytics economists, visit Economic View.

David Tuller returns to TWiV to discuss RFK Jr. and the trashing of American public health, rituximab and ME/CFS, The Sick Times, the Cochrane Mess, a Norwegian Long Covid trial, effort preference and more. Host: Vincent Racaniello Guest: David Tuller Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Become a patron of TWiV! Links for this episode MicrobeTV Discord Server David Tuller writes at virology blog CFS, a long tangled tale (virology blog) The Sick Times Norwegian Long COVID trial (virology blog) Cochrane mess (virology blog) Timestamps by Jolene. Thanks! Intro music is by Ronald Jenkees Send your virology questions and comments to twiv@microbe.tv Content on TWiV should not be taken as medical advice.

The Lord's Own Prayer, Part 1 - Dan Cochrane

Spurs Chat: Discussing all Things Tottenham Hotspur: Hosted by Chris Cowlin: The Daily Tottenham/Spurs Podcast Hosted on Acast. See acast.com/privacy for more information.

In this episode of the Data Center Frontier Show, we sit down with Kevin Cochrane, Chief Marketing Officer of Vultr, to explore how the company is positioning itself at the forefront of AI-native cloud infrastructure, and why they're all-in on AMD's GPUs, open-source software, and a globally distributed strategy for the future of inference. Cochrane begins by outlining the evolution of the GPU market, moving from a scarcity-driven, centralized training era to a new chapter focused on global inference workloads. With enterprises now seeking to embed AI across every application and workflow, Vultr is preparing for what Cochrane calls a “10-year rebuild cycle” of enterprise infrastructure—one that will layer GPUs alongside CPUs across every corner of the cloud. Vultr's recent partnership with AMD plays a critical role in that strategy. The company is deploying both the MI300X and MI325X GPUs across its 32 data center regions, offering customers optimized options for inference workloads. Cochrane explains the advantages of AMD's chips, such as higher VRAM and power efficiency, which allow large models to run with fewer GPUs—boosting both performance and cost-effectiveness. These deployments are backed by Vultr's close integration with Supermicro, which delivers the rack-scale servers needed to bring new GPU capacity online quickly and reliably. Another key focus of the episode is ROCm (Radeon Open Compute), AMD's open-source software ecosystem for AI and HPC workloads. Cochrane emphasizes that Vultr is not just deploying AMD hardware; it's fully aligned with the open-source movement underpinning it. He highlights Vultr's ongoing global ROCm hackathons and points to zero-day ROCm support on platforms like Hugging Face as proof of how open standards can catalyze rapid innovation and developer adoption. “Open source and open standards always win in the long run,” Cochrane says. “The future of AI infrastructure depends on a global, community-driven ecosystem, just like the early days of cloud.” The conversation wraps with a look at Vultr's growth strategy following its $3.5 billion valuation and recent funding round. Cochrane envisions a world where inference workloads become ubiquitous and deeply embedded into everyday life—from transportation to customer service to enterprise operations. That, he says, will require a global fabric of low-latency, GPU-powered infrastructure. “The world is going to become one giant inference engine,” Cochrane concludes. “And we're building the foundation for that today.” Tune in to hear how Vultr's bold moves in open-source AI infrastructure and its partnership with AMD may shape the next decade of cloud computing, one GPU cluster at a time.

Spurs Chat: Discussing all Things Tottenham Hotspur: Hosted by Chris Cowlin: The Daily Tottenham/Spurs Podcast Hosted on Acast. See acast.com/privacy for more information.

In this episode of Embracing Your Voice, Atima welcomes music industry veteran, writer, and cultural commentator Naima Cochrane for an inspiring conversation about building a career that aligns with your true self. From her early days in entertainment law to leading marketing at iconic labels and managing artists like John Legend, Naima shares her journey through a changing industry. Tune in as they discuss navigating creative careers, the evolution of Black music and culture, and lessons on embracing the parts of yourself that make you stand out.Key TakeawaysCareer Alignment Comes Over Time: Naima shares how her current career—teaching, writing, and storytelling—is the most aligned with who she has always been.The Power of Storytelling in Marketing: Through her marketing work at major labels, Naima learned that telling the artist's story is as critical as promoting their music.Managing Talent Is About Trust: Her time managing John Legend revealed how essential communication, trust, and healthy boundaries are in artist management.Episode Highlights[00:01:00] — Naima's early life growing up in a musical family; roots of her love for music.[00:09:00] — Moving from a corporate marketing career into freelance and entrepreneurship.[00:17:00] — How #MusicSermon began as a passion project on Twitter.[00:24:00] — Building an authentic community online and resisting pressure to monetize early.[00:31:00] — The moment #MusicSermon unexpectedly launched her journalism career.[00:36:00] — Balancing full-time teaching with creative and entrepreneurial work.[00:42:00] — Dealing with perfectionism and ADHD when creating content.[00:49:00] — How her values drive her work and decision-making.[00:55:00] — The challenges of scaling as a solo creative — when and how to bring on help.[01:03:00] — Learning to embrace being seen as a thought leader in music and culture.[01:14:00] — Community is the true driver of #Music Sermon — why she continues to resist monetization that changes the experience.[01:15:00] — How #Music Sermon opened doors to journalism, teaching, and partnerships.[01:23:00] — Leading the award-winning marketing campaign for Aaliyah's catalog release.[01:27:00] — Learning to promote her own voice and accomplishments after years of building others'.[01:33:00] — Final advice for creatives: sell your unique voice, trust the process, and give yourself grace.Quotes"Everything that I do now reflects little Naima in a really great way—even the parts of myself I once tried to turn down." — Naima Cochrane"Marketing is where you get to tell the artist's story, explain the vision, and help shape how the world sees them." — Naima Cochrane"As a manager, your job is to free the talent to be creative. You take on the logistics so they can focus on their art." — Naima CochraneNaima Cochrane is a music industry veteran who is a storyteller, and leading voice on Black music and culture. She spent 20 years rising through the ranks at legendary music labels Arista, Columbia and Epic Records. She would then work on the artist management side with EGOT John Legend and Emmy, Grammy, and Tony award winning Cynthia Erivo. Now, she is best known for being the creator of the viral storytelling series on Twitter and Instagram called #MusicSermon which prompted a move from the business side into more music...

We talk Roots picnic, The Clipse album, Ms. Shirley, Rodney Hinton, and the Diddy trials. Subscribe and spread the word!! The post Black Fatigue first appeared on The Poplife Podcast.

Hello everyone! Thanks to Tom's holiday and Stuart's job we weren't able to record this week, so we've put out a classic paid episode to tide you over. We hope this goes some way to scratching your Studies Show itch.Most people think it's obvious that you should wear a helmet when cycling. It might save your life if you fall off and hit your head. Duh.But over the years, many contrarian arguments have pushed back against this seemingly-obvious point. What if people engage in “risk compensation”, where they cycle more dangerously because they know they're wearing a helmet? What about if encouraging helments puts people off cycling so they miss the health benefits?In this March 2024 episode of The Studies Show, Tom and Stuart try to work out who's right.Show notes* The original 1975 study on what's become known as the “Peltzman Effect”: risk compensation (in this case about car safety)* Potential evidence for risk compensation in AIDS* Claims of risk compensation relating to mask-wearing at the start of the COVID-19 pandemic* The eye-tracking study on helmet-wearing, which used the Balloon Analogue Risk-Taking lab task* n=27 study on helmets and cycling with one hand on the handlebar* Study on risk compensation with the following confusing structural equation model diagram:* Academic cycles around and records thousands of cars passing him while he's either wearing or not wearing a helmet* Forbes article about the statistical controversy over these data* Bizarre study on how motorists “dehumanize” cyclists* Could helmets make “rotational injuries” worse?* Cochrane review on cycle helmets and injuries from 1999* Ben Goldacre and David Spiegelhalter on cycle helmets - “uncertainty… is unlikely to be substantially reduced by further research”* Systematic review on helmet use and injuries from 2016* Review of meta-analyses from 2023* 2006 BMJ article finding “no clear evidence” that mandating cycle helmets reduces injuries* Negative correlation between cycle numbers and helmet usage, across different countriesCreditsThe Studies Show is produced by Julian Mayers at Yada Yada Productions. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.thestudiesshowpod.com/subscribe

Jamie Hartmann-Boyce and Nicola Lindson discuss emerging evidence in e-cigarette research and interview Steve Cook from the University of Michigan USA about the importance of correctly interpreting and assessing the available data. Associate Professor Jamie Hartmann-Boyce and Associate Professor Nicola Lindson discuss the new evidence in e-cigarette research and interview Dr Steven Cook from the Department of Epidemiology, School of Public Health University of Michigan and the Centre for Assessment of Tobacco Regulations, University of Michigan. In the May podcast Steve Cook discusses the methodological problems of cross-sectional data on the health effects of e-cigarette use a topic he addressed at the May 2025 EC Summit, Washington DC. Steve Cook underlines why all cross-sectional health effects studies should be interpreted with extreme caution unless they examine dose-response relationships and account for temporality and cigarette smoking confounding. Dr Cook emphasises the importance of other information such as smoking histories and health histories and the importance of developing a best practice to ensure that we minimize the risks associated with spurious association and maximise predictive accuracy. Steven Cook receives National Institute for Health (NIH) and Food and Drug Administration's (FDA) Center for Tobacco Products (CTP) funding. This is not deemed a conflict of interest. EC Summit, Washington DC: https://www.e-cigarette-summit.com/program-2025/ Recent paper: 10.1016/j.isci.2025.111985 This podcast is a companion to the electronic cigarettes Cochrane living systematic review and Interventions for quitting vaping review and shares the evidence from the monthly searches. Our search for the EC for smoking cessation review carried out on 1st May 2025 found 1 ongoing (NCT06922617) and 1 linked study (DOI: 10.1101/2025.02.17.25322409). Our search for our interventions for quitting vaping review up to 1st May 2025 found 1 new (DOI 10.1001/jama.2025.3810) and 4 ongoing studies (DOI 10.2196/71961, KCT0010346, NCT06909500, NCT06929520). For further details see our webpage under 'Monthly search findings': https://www.cebm.ox.ac.uk/research/electronic-cigarettes-for-smoking-cessation-cochrane-living-systematic-review-1 For more information on the full Cochrane review of E-cigarettes for smoking cessation updated in January 2025 see: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010216.pub9/full For more information on the full Cochrane review of Interventions for quitting vaping published in January 2025 see: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD016058.pub2/full This podcast is supported by Cancer Research UK.

Good Sunday morning to you,I am just on a train home from Glasgow, where I have been gigging these past two nights. I've had a great time, as I always seem to do when I go north of the wall.But Glasgow on a Saturday night is something else. My hotel was right next to the station and so I was right in the thick of it. If I ever get to make a cacatopian, end-of-days, post-apocalyptic thriller, I'll just stroll through Glasgow city centre on a Friday or Saturday night with a camera to get all the B roll. It was like walking through a Hieronymus Bosch painting only with a Scottish accent. Little seems to have changed since I wrote that infamous chapter about Glasgow in Life After the State all those years ago. The only difference is that now it's more multi-ethnic. So many people are so off their heads. I lost count of the number of randoms wandering about just howling at the stars. The long days - it was still light at 10 o'clock - make the insanity all the more visible. Part of me finds it funny, but another part of me finds it so very sad that so many people let themselves get into this condition. It prompted me to revisit said chapter, and I offer it today as your Sunday thought piece.Just a couple of little notes, before we begin. This caught my eye on Friday. Our favourite uranium tech company, Lightbridge Fuels (NASDAQ:LTBR), has taken off again with Donald Trump's statement that he is going to quadruple US nuclear capacity. The stock was up 45% in a day. We first looked at it in October at $3. It hit $15 on Friday. It's one to sell on the spikes and buy on the dips, as this incredible chart shows.(In other news I have now listened twice to the Comstock Lode AGM, and I'll report back on that shortly too). ICYMI here is my mid-week commentary, which attracted a lot of attentionRight - Glasgow.(NB I haven't included references here. Needless to say, they are all there in the book. And sorry I don't have access to the audio of me reading this from my laptop, but, if you like, you can get the audiobook at Audible, Apple Books and all good audiobookshops. The book itself available at Amazon, Apple Books et al).How the Most Entrepreneurial City in Europe Became Its SickestThe cause of waves of unemployment is not capitalism, but governments …Friedrich Hayek, economist and philosopherIn the 18th and 19th centuries, the city of Glasgow in Scotland became enormously, stupendously rich. It happened quite organically, without planning. An entrepreneurial people reacted to their circumstances and, over time, turned Glasgow into an industrial and economic centre of such might that, by the turn of the 20th century, Glasgow was producing half the tonnage of Britain's ships and a quarter of all locomotives in the world. (Not unlike China's industrial dominance today). It was regarded as the best-governed city in Europe and popular histories compared it to the great imperial cities of Venice and Rome. It became known as the ‘Second City of the British Empire'.Barely 100 years later, it is the heroin capital of the UK, the murder capital of the UK and its East End, once home to Europe's largest steelworks, has been dubbed ‘the benefits capital of the UK'. Glasgow is Britain's fattest city: its men have Britain's lowest life expectancy – on a par with Palestine and Albania – and its unemployment rate is 50% higher than the rest of the UK.How did Glasgow manage all that?The growth in Glasgow's economic fortunes began in the latter part of the 17th century and the early 18th century. First, the city's location in the west of Scotland at the mouth of the river Clyde meant that it lay in the path of the trade winds and at least 100 nautical miles closer to America's east coast than other British ports – 200 miles closer than London. In the days before fossil fuels (which only found widespread use in shipping in the second half of the 19th century) the journey to Virginia was some two weeks shorter than the same journey from London or many of the other ports in Britain and Europe. Even modern sailors describe how easy the port of Glasgow is to navigate. Second, when England was at war with France – as it was repeatedly between 1688 and 1815 – ships travelling to Glasgow were less vulnerable than those travelling to ports further south. Glasgow's merchants took advantage and, by the early 18th century, the city had begun to assert itself as a trading hub. Manufactured goods were carried from Britain and Europe to North America and the Caribbean, where they were traded for increasingly popular commodities such as tobacco, cotton and sugar.Through the 18th century, the Glasgow merchants' business networks spread, and they took steps to further accelerate trade. New ships were introduced, bigger than those of rival ports, with fore and aft sails that enabled them to sail closer to the wind and reduce journey times. Trading posts were built to ensure that cargo was gathered and stored for collection, so that ships wouldn't swing idly at anchor. By the 1760s Glasgow had a 50% share of the tobacco trade – as much as the rest of Britain's ports combined. While the English merchants simply sold American tobacco in Europe at a profit, the Glaswegians actually extended credit to American farmers against future production (a bit like a crop future today, where a crop to be grown at a later date is sold now). The Virginia farmers could then use this credit to buy European goods, which the Glaswegians were only too happy to supply. This brought about the rise of financial institutions such as the Glasgow Ship Bank and the Glasgow Thistle Bank, which would later become part of the now-bailed-out, taxpayer-owned Royal Bank of Scotland (RBS).Their practices paid rewards. Glasgow's merchants earned a great deal of money. They built glamorous homes and large churches and, it seems, took on aristocratic airs – hence they became known as the ‘Tobacco Lords'. Numbering among them were Buchanan, Dunlop, Ingram, Wilson, Oswald, Cochrane and Glassford, all of whom had streets in the Merchant City district of Glasgow named after them (other streets, such as Virginia Street and Jamaica Street, refer to their trade destinations). In 1771, over 47 million pounds of tobacco were imported.However, the credit the Glaswegians extended to American tobacco farmers would backfire. The debts incurred by the tobacco farmers – which included future presidents George Washington and Thomas Jefferson (who almost lost his farm as a result) – grew, and were among the grievances when the American War of Independence came in 1775. That war destroyed the tobacco trade for the Glaswegians. Much of the money that was owed to them was never repaid. Many of their plantations were lost. But the Glaswegians were entrepreneurial and they adapted. They moved on to other businesses, particularly cotton.By the 19th century, all sorts of local industry had emerged around the goods traded in the city. It was producing and exporting textiles, chemicals, engineered goods and steel. River engineering projects to dredge and deepen the Clyde (with a view to forming a deep- water port) had begun in 1768 and they would enable shipbuilding to become a major industry on the upper reaches of the river, pioneered by industrialists such as Robert Napier and John Elder. The final stretch of the Monkland Canal, linking the Forth and Clyde Canal at Port Dundas, was opened in 1795, facilitating access to the iron-ore and coal mines of Lanarkshire.The move to fossil-fuelled shipping in the latter 19th century destroyed the advantages that the trade winds had given Glasgow. But it didn't matter. Again, the people adapted. By the turn of the 20th century the Second City of the British Empire had become a world centre of industry and heavy engineering. It has been estimated that, between 1870 and 1914, it produced as much as one-fifth of the world's ships, and half of Britain's tonnage. Among the 25,000 ships it produced were some of the greatest ever built: the Cutty Sark, the Queen Mary, HMS Hood, the Lusitania, the Glenlee tall ship and even the iconic Mississippi paddle steamer, the Delta Queen. It had also become a centre for locomotive manufacture and, shortly after the turn of the 20th century, could boast the largest concentration of locomotive building works in Europe.It was not just Glasgow's industry and wealth that was so gargantuan. The city's contribution to mankind – made possible by the innovation and progress that comes with booming economies – would also have an international impact. Many great inventors either hailed from Glasgow or moved there to study or work. There's James Watt, for example, whose improvements to the steam engine were fundamental to the Industrial Revolution. One of Watt's employees, William Murdoch, has been dubbed ‘the Scot who lit the world' – he invented gas lighting, a new kind of steam cannon and waterproof paint. Charles MacIntosh gave us the raincoat. James Young, the chemist dubbed as ‘the father of the oil industry', gave us paraffin. William Thomson, known as Lord Kelvin, developed the science of thermodynamics, formulating the Kelvin scale of absolute temperature; he also managed the laying of the first transatlantic telegraph cable.The turning point in the economic fortunes of Glasgow – indeed, of industrial Britain – was WWI. Both have been in decline ever since. By the end of the war, the British were drained, both emotionally and in terms of capital and manpower; the workers, the entrepreneurs, the ideas men, too many of them were dead or incapacitated. There was insufficient money and no appetite to invest. The post-war recession, and later the Great Depression, did little to help. The trend of the city was now one of inexorable economic decline.If Glasgow was the home of shipping and industry in 19th-century Britain, it became the home of socialism in the 20th century. Known by some as the ‘Red Clydeside' movement, the socialist tide in Scotland actually pre-dated the First World War. In 1906 came the city's first Labour Member of Parliament (MP), George Barnes – prior to that its seven MPs were all Conservatives or Liberal Unionists. In the spring of 1911, 11,000 workers at the Singer sewing-machine factory (run by an American corporation in Clydebank) went on strike to support 12 women who were protesting about new work practices. Singer sacked 400 workers, but the movement was growing – as was labour unrest. In the four years between 1910 and 1914 Clydebank workers spent four times as many days on strike than in the whole of the previous decade. The Scottish Trades Union Congress and its affiliations saw membership rise from 129,000 in 1909 to 230,000 in 1914.20The rise in discontent had much to do with Glasgow's housing. Conditions were bad, there was overcrowding, bad sanitation, housing was close to dirty, noxious and deafening industry. Unions grew quite organically to protect the interests of their members.Then came WWI, and inflation, as Britain all but abandoned gold. In 1915 many landlords responded by attempting to increase rent, but with their young men on the Western front, those left behind didn't have the means to pay these higher costs. If they couldn't, eviction soon followed. In Govan, an area of Glasgow where shipbuilding was the main occupation, women – now in the majority with so many men gone – organized opposition to the rent increases. There are photographs showing women blocking the entrance to tenements; officers who did get inside to evict tenants are said to have had their trousers pulled down.The landlords were attacked for being unpatriotic. Placards read: ‘While our men are fighting on the front line,the landlord is attacking us at home.' The strikes spread to other cities throughout the UK, and on 27 November 1915 the government introduced legislation to restrict rents to the pre-war level. The strikers were placated. They had won. The government was happy; it had dealt with the problem. The landlords lost out.In the aftermath of the Russian Revolution of 1917, more frequent strikes crippled the city. In 1919 the ‘Bloody Friday' uprising prompted the prime minister, David Lloyd George, to deploy 10,000 troops and tanks onto the city's streets. By the 1930s Glasgow had become the main base of the Independent Labour Party, so when Labour finally came to power alone after WWII, its influence was strong. Glasgow has always remained a socialist stronghold. Labour dominates the city council, and the city has not had a Conservative MP for 30 years.By the late 1950s, Glasgow was losing out to the more competitive industries of Japan, Germany and elsewhere. There was a lack of investment. Union demands for workers, enforced by government legislation, made costs uneconomic and entrepreneurial activity arduous. With lack of investment came lack of innovation.Rapid de-industrialization followed, and by the 1960s and 70s most employment lay not in manufacturing, but in the service industries.Which brings us to today. On the plus side, Glasgow is still ranked as one of Europe's top 20 financial centres and is home to some leading Scottish businesses. But there is considerable downside.Recent studies have suggested that nearly 30% of Glasgow's working age population is unemployed. That's 50% higher than that of the rest of Scotland or the UK. Eighteen per cent of 16- to 19-year-olds are neither in school nor employed. More than one in five working-age Glaswegians have no sort of education that might qualify them for a job.In the city centre, the Merchant City, 50% of children are growing up in homes where nobody works. In the poorer neighbourhoods, such as Ruchill, Possilpark, or Dalmarnock, about 65% of children live in homes where nobody works – more than three times the national average. Figures from the Department of Work and Pensions show that 85% of working age adults from the district of Bridgeton claim some kind of welfare payment.Across the city, almost a third of the population regularly receives sickness or incapacity benefit, the highest rate of all UK cities. A 2008 World Health Organization report noted that in Glasgow's Calton, Bridgeton and Queenslie neighbourhoods, the average life expectancy for males is only 54. In contrast, residents of Glasgow's more affluent West End live to be 80 and virtually none of them are on the dole.Glasgow has the highest crime rate in Scotland. A recent report by the Centre for Social Justice noted that there are 170 teenage gangs in Glasgow. That's the same number as in London, which has over six times the population of Glasgow.It also has the dubious record of being Britain's murder capital. In fact, Glasgow had the highest homicide rate in Western Europe until it was overtaken in 2012 by Amsterdam, with more violent crime per head of population than even New York. What's more, its suicide rate is the highest in the UK.Then there are the drug and alcohol problems. The residents of the poorer neighbourhoods are an astounding six times more likely to die of a drugs overdose than the national average. Drug-related mortality has increased by 95% since 1997. There are 20,000 registered drug users – that's just registered – and the situation is not going to get any better: children who grow up in households where family members use drugs are seven times more likely to end up using drugs themselves than children who live in drug-free families.Glasgow has the highest incidence of liver diseases from alcohol abuse in all of Scotland. In the East End district of Dennistoun, these illnesses kill more people than heart attacks and lung cancer combined. Men and women are more likely to die of alcohol-related deaths in Glasgow than anywhere else in the UK. Time and time again Glasgow is proud winner of the title ‘Fattest City in Britain'. Around 40% of the population are obese – 5% morbidly so – and it also boasts the most smokers per capita.I have taken these statistics from an array of different sources. It might be in some cases that they're overstated. I know that I've accentuated both the 18th- and 19th-century positives, as well as the 20th- and 21st-century negatives to make my point. Of course, there are lots of healthy, happy people in Glasgow – I've done many gigs there and I loved it. Despite the stories you hear about intimidating Glasgow audiences, the ones I encountered were as good as any I've ever performed in front of. But none of this changes the broad-brush strokes: Glasgow was a once mighty city that now has grave social problems. It is a city that is not fulfilling its potential in the way that it once did. All in all, it's quite a transformation. How has it happened?Every few years a report comes out that highlights Glasgow's various problems. Comments are then sought from across the political spectrum. Usually, those asked to comment agree that the city has grave, ‘long-standing and deep-rooted social problems' (the words of Stephen Purcell, former leader of Glasgow City Council); they agree that something needs to be done, though they don't always agree on what that something is.There's the view from the right: Bill Aitken of the Scottish Conservatives, quoted in The Sunday Times in 2008, said, ‘We simply don't have the jobs for people who are not academically inclined. Another factor is that some people are simply disinclined to work. We have got to find something for these people to do, to give them a reason to get up in the morning and give them some self-respect.' There's the supposedly apolitical view of anti-poverty groups: Peter Kelly, director of the Glasgow-based Poverty Alliance, responded, ‘We need real, intensive support for people if we are going to tackle poverty. It's not about a lack of aspiration, often people who are unemployed or on low incomes are stymied by a lack of money and support from local and central government.' And there's the view from the left. In the same article, Patricia Ferguson, the Labour Member of the Scottish Parliament (MSP) for Maryhill, also declared a belief in government regeneration of the area. ‘It's about better housing, more jobs, better education and these things take years to make an impact. I believe that the huge regeneration in the area is fostering a lot more community involvement and cohesion. My real hope is that these figures will take a knock in the next five or ten years.' At the time of writing in 2013, five years later, the figures have worsened.All three points of view agree on one thing: the government must do something.In 2008 the £435 million Fairer Scotland Fund – established to tackle poverty – was unveiled, aiming to allocate cash to the country's most deprived communities. Its targets included increasing average income among lower wage-earners and narrowing the poverty gap between Scotland's best- and worst-performing regions by 2017. So far, it hasn't met those targets.In 2008 a report entitled ‘Power for The Public' examined the provision of health, education and justice in Scotland. It said the budgets for these three areas had grown by 55%, 87% and 44% respectively over the last decade, but added that this had produced ‘mixed results'. ‘Mixed results' means it didn't work. More money was spent and the figures got worse.After the Centre for Social Justice report on Glasgow in 2008, Iain Duncan Smith (who set up this think tank, and is now the Secretary of State for Work and Pensions) said, ‘Policy must deal with the pathways to breakdown – high levels of family breakdown, high levels of failed education, debt and unemployment.'So what are ‘pathways to breakdown'? If you were to look at a chart of Glasgow's prosperity relative to the rest of the world, its peak would have come somewhere around 1910. With the onset of WWI in 1914 its decline accelerated, and since then the falls have been relentless and inexorable. It's not just Glasgow that would have this chart pattern, but the whole of industrial Britain. What changed the trend? Yes, empires rise and fall, but was British decline all a consequence of WWI? Or was there something else?A seismic shift came with that war – a change which is very rarely spoken or written about. Actually, the change was gradual and it pre-dated 1914. It was a change that was sweeping through the West: that of government or state involvement in our lives. In the UK it began with the reforms of the Liberal government of 1906–14, championed by David Lloyd George and Winston Churchill, known as the ‘terrible twins' by contemporaries. The Pensions Act of 1908, the People's Budget of 1909–10 (to ‘wage implacable warfare against poverty', declared Lloyd George) and the National Insurance Act of 1911 saw the Liberal government moving away from its tradition of laissez-faire systems – from classical liberalism and Gladstonian principles of self-help and self-reliance – towards larger, more active government by which taxes were collected from the wealthy and the proceeds redistributed. Afraid of losing votes to the emerging Labour party and the increasingly popular ideology of socialism, modern liberals betrayed their classical principles. In his War Memoirs, Lloyd George said ‘the partisan warfare that raged around these topics was so fierce that by 1913, this country was brought to the verge of civil war'. But these were small steps. The Pensions Act, for example, meant that men aged 70 and above could claim between two and five shillings per week from the government. But average male life- expectancy then was 47. Today it's 77. Using the same ratio, and, yes, I'm manipulating statistics here, that's akin to only awarding pensions to people above the age 117 today. Back then it was workable.To go back to my analogy of the prologue, this period was when the ‘train' was set in motion across the West. In 1914 it went up a gear. Here are the opening paragraphs of historian A. J. P. Taylor's most celebrated book, English History 1914–1945, published in 1965.I quote this long passage in full, because it is so telling.Until August 1914 a sensible, law-abiding Englishman could pass through life and hardly notice the existence of the state, beyond the post office and the policeman. He could live where he liked and as he liked. He had no official number or identity card. He could travel abroad or leave his country forever without a passport or any sort of official permission. He could exchange his money for any other currency without restriction or limit. He could buy goods from any country in the world on the same terms as he bought goods at home. For that matter, a foreigner could spend his life in this country without permit and without informing the police. Unlike the countries of the European continent, the state did not require its citizens to perform military service. An Englishman could enlist, if he chose, in the regular army, the navy, or the territorials. He could also ignore, if he chose, the demands of national defence. Substantial householders were occasionally called on for jury service. Otherwise, only those helped the state, who wished to do so. The Englishman paid taxes on a modest scale: nearly £200 million in 1913–14, or rather less than 8% of the national income.The state intervened to prevent the citizen from eating adulterated food or contracting certain infectious diseases. It imposed safety rules in factories, and prevented women, and adult males in some industries,from working excessive hours.The state saw to it that children received education up to the age of 13. Since 1 January 1909, it provided a meagre pension for the needy over the age of 70. Since 1911, it helped to insure certain classes of workers against sickness and unemployment. This tendency towards more state action was increasing. Expenditure on the social services had roughly doubled since the Liberals took office in 1905. Still, broadly speaking, the state acted only to help those who could not help themselves. It left the adult citizen alone.All this was changed by the impact of the Great War. The mass of the people became, for the first time, active citizens. Their lives were shaped by orders from above; they were required to serve the state instead of pursuing exclusively their own affairs. Five million men entered the armed forces, many of them (though a minority) under compulsion. The Englishman's food was limited, and its quality changed, by government order. His freedom of movement was restricted; his conditions of work prescribed. Some industries were reduced or closed, others artificially fostered. The publication of news was fettered. Street lights were dimmed. The sacred freedom of drinking was tampered with: licensed hours were cut down, and the beer watered by order. The very time on the clocks was changed. From 1916 onwards, every Englishman got up an hour earlier in summer than he would otherwise have done, thanks to an act of parliament. The state established a hold over its citizens which, though relaxed in peacetime, was never to be removed and which the Second World war was again to increase. The history of the English state and of the English people merged for the first time.Since the beginning of WWI , the role that the state has played in our lives has not stopped growing. This has been especially so in the case of Glasgow. The state has spent more and more, provided more and more services, more subsidy, more education, more health care, more infrastructure, more accommodation, more benefits, more regulations, more laws, more protection. The more it has provided, the worse Glasgow has fared. Is this correlation a coincidence? I don't think so.The story of the rise and fall of Glasgow is a distilled version of the story of the rise and fall of industrial Britain – indeed the entire industrial West. In the next chapter I'm going to show you a simple mistake that goes on being made; a dynamic by which the state, whose very aim was to help Glasgow, has actually been its ‘pathway to breakdown' . . .Life After the State is available at Amazon, Apple Books and all good bookshops, with the audiobook at Audible, Apple Books and all good audiobookshops. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.theflyingfrisby.com/subscribe

In this episode of the Science of Slink podcast, Dr. Rosy Boa delves into the intricacies of learning pole dance at home. With a background in pole dance since 2012 and instruction since 2018, she brings extensive experience and scientific insights to the discussion. The episode covers the effectiveness of home-based exercise supported by recent research, methods to maintain motivation, and strategies to avoid common injuries. Dr. Boa shares her 'pyramid of pole' framework to guide beginners through physical conditioning, technical learning, and artistic expression. The episode also explores how to adapt training routines to home environments, addressing space limitations, flooring types, and unique home dynamics like pets or kids. Finally, Dr. Boa highlights the importance of appropriate movement levels and offers specific recommendations for home pole dance practice, urging listeners to be patient and consistent in their training.Are you a pole nerd interested in trying out online pole classes with Slink Through Strength? We'd love to have you! Use the code “podcast” for 10% off the Intro Pack and try out all of our unique online pole classes: https://app.acuityscheduling.com/catalog/25a67bd1/?productId=1828315&clearCart=true Citations: McDonagh, S. T., Dalal, H., Moore, S., Clark, C. E., Dean, S. G., Jolly, K., ... & Taylor, R. S. (2023). Home‐based versus centre‐based cardiac rehabilitation. Cochrane database of systematic reviews, (10).Schutzer, K. A., & Graves, B. S. (2004). Barriers and motivations to exercise in older adults. Preventive medicine, 39(5), 1056-1061.Lee, J. Y., Lin, L., & Tan, A. (2019). Prevalence of pole dance injuries from a global online survey. The Journal of sports medicine and physical fitness, 60(2), 270-275.Nicholas, J., Weir, G., Alderson, J. A., Stubbe, J. H., Van Rijn, R. M., Dimmock, J. A., ... & Donnelly, C. J. (2022). Incidence, mechanisms, and characteristics of injuries in pole dancers: a prospective cohort study. Medical problems of performing artists, 37(3), 151-164.Dang, Y., Chen, R., Koutedakis, Y., & Wyon, M. A. (2023). The efficacy of physical fitness training on dance injury: a systematic review. International journal of sports medicine, 44(02), 108-116.Ambegaonkar, J. P., Chong, L., & Joshi, P. (2021). Supplemental training in dance: a systematic review. Physical Medicine and Rehabilitation Clinics, 32(1), 117-135.Bohm, S., Mersmann, F., & Arampatzis, A. (2015). Human tendon adaptation in response to mechanical loading: a systematic review and meta-analysis of exercise intervention studies on healthy adults. Sports medicine-open, 1, 1-18.Chapters:00:00 Introduction to the Science of Slink Podcast02:24 The Benefits of Home-Based Pole Dance Training06:54 Building Physical Capacity for Pole Dance08:23 Cross Training and Injury Prevention14:09 Considerations for Home Pole Dancers18:00 Recommendations for Beginners21:20 The Science of Slink Membership23:21 Conclusion and Final Thoughts

Jim Cochrane – Chief Business Officer at the Texas Rangers – and Jon Heidtke – Founder and Principal at Heidtke Sports Entertainment were featured on the very first episode of our Navigating Sports Media Series. In this highlight, Jon breaks down the unique distribution model that they created which combines regional distribution, OTA broadcast, and a direct-to-consumer option in order to reach as many Rangers fans as possible.   He shares how they were able to manage relationships with different partners throughout the process, and the hard work that went into creating Rangers Sports Network.   Listen to the full episode here: https://nvgt.com/podcast?ppplayer=1e977ebc536a4f7840f232ca6e253547&ppepisode=94bf2e252950ffa46e031485ed9e76dc   For more insights, visit our LinkedIn page or learn more about Navigate at https://nvgt.com/.

Now from her permanent studio overlooking the French River Laurie Cochrane puts her mind and spirit into stunning paintings. Come along and listen as she discribes the colours, formats, and content of art that just pleases the soul of those from northern Ontario. Wispy bent white pines may be stereotypic, but they are so comforting... you can almost hear the wind singing in their needles.

We're joined by mystic and light worker Justin Patrick Cochrane, whose journey through addiction, a near-death experience, and ultimately into the arms of Jesus Christ is nothing short of miraculous. In this conversation, Justin walks us through the sacred simplicity of prayer, what it means to live as a vessel for God, and how to bring spiritual connection into the ordinary moments of daily life. We talk about how to actually hear God's voice (and how to tell it apart from the ego, which can be sneaky and spiritual-sounding), how sobriety can become a portal to divine clarity, and why it's safe—and necessary—to fully surrender. Whether you're new to faith, returning after a long time, or deepening your walk with Jesus, this episode will speak to your soul. Expect to feel seen, grounded, and more connected to the Light that's always been guiding you. We love hearing from you!DM us with questions, comments, coaching inquiries, or episode topic ideas. Let's connect! Follow us on Instagram → @2sobergirlspodcastJoin our VIP email list → 2sobergirls.com/vip Sober SupportJoin the Sober Girls Mastermind—a space for women ready to transform their relationship with alcohol and fully heal body, mind, and spirit. Inside: weekly group calls, expert masterclasses, exclusive trainings, private group chat, and direct support from Michaela & Erinn. Grab your FREE course on our website: The Sober Girl BlueprintYour roadmap to ditching cravings, building rituals, and living an empowered alcohol-free life. Resources & Support Connect with us:Michaela on Instagram | Download Michaela's Free ResourcesErinn on Instagram | Get Erinn's Sober Life Simplified Guide Loved the episode? Treat us to a coffee: buymeacoffee.com/2sobergirlspodcast Don't forget to rate, review, and share the show!Subscribe so you never miss an episode. Support our sponsors: 2sobergirls.com/sponsors Disclaimer: We are not addiction specialists, but we can help guide you to the right support if needed. This podcast is intended to inspire, educate, and support your personal journey. It is not medical advice. Learn more about your ad choices. Visit megaphone.fm/adchoices

We're joined by mystic and light worker Justin Patrick Cochrane, whose journey through addiction, a near-death experience, and ultimately into the arms of Jesus Christ is nothing short of miraculous. In this conversation, Justin walks us through the sacred simplicity of prayer, what it means to live as a vessel for God, and how to bring spiritual connection into the ordinary moments of daily life. We talk about how to actually hear God's voice (and how to tell it apart from the ego, which can be sneaky and spiritual-sounding), how sobriety can become a portal to divine clarity, and why it's safe—and necessary—to fully surrender. Whether you're new to faith, returning after a long time, or deepening your walk with Jesus, this episode will speak to your soul. Expect to feel seen, grounded, and more connected to the Light that's always been guiding you. We love hearing from you!DM us with questions, comments, coaching inquiries, or episode topic ideas. Let's connect! Follow us on Instagram → @2sobergirlspodcastJoin our VIP email list → 2sobergirls.com/vip Sober SupportJoin the Sober Girls Mastermind—a space for women ready to transform their relationship with alcohol and fully heal body, mind, and spirit. Inside: weekly group calls, expert masterclasses, exclusive trainings, private group chat, and direct support from Michaela & Erinn. Grab your FREE course on our website: The Sober Girl BlueprintYour roadmap to ditching cravings, building rituals, and living an empowered alcohol-free life. Resources & Support Connect with us:Michaela on Instagram | Download Michaela's Free ResourcesErinn on Instagram | Get Erinn's Sober Life Simplified Guide Loved the episode? Treat us to a coffee: buymeacoffee.com/2sobergirlspodcast Don't forget to rate, review, and share the show!Subscribe so you never miss an episode. Support our sponsors: 2sobergirls.com/sponsors Disclaimer: We are not addiction specialists, but we can help guide you to the right support if needed. This podcast is intended to inspire, educate, and support your personal journey. It is not medical advice. Learn more about your ad choices. Visit megaphone.fm/adchoicesSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Vegan Boss Radio is back!

Jamie Hartmann-Boyce and Nicola Lindson explore new e-cigarette research and speak with Eden Evins from Massachusetts General Hospital and Harvard Medical School, about her randomized clinical trial on varenicline for youth vaping cessation. Associate Professor Jamie Hartmann-Boyce and Associate Professor Nicola Lindson discuss the new evidence in e-cigarette research and interview Professor Eden Evins from Massachusetts General Hospital and Harvard Medical School, Boston. In the April podcast Eden Evins discusses the findings of their new randomised clinical trial to evaluate the efficacy of varenicline for nicotine vaping cessation in 261 treatment seeking youth (16-24 years) who do not smoke tobacco regularly. This study has just been published in JAMA, April 2025 (DOI:10.1001/jama.2025.3810 NCT05367492). Professor Evins describes her interest in the high use of vapes among young people and the speed at which this increase to a different flavoured form of nicotine has occurred. Professor Evins and her team thought that varenicline, a pill based drug that is used for quitting smoking, could work for vaping cessation. She talks about the huge demand to take part in the study and how the team had to pause recruitment to keep up. She describes how young people were indignant, they had not expected to become addicted. Professor Evins says that when young people found they couldn't sit through a study session without needing to vape they were surprised and felt taken advantage of by marketers and these flavored products that they had thought were for fun. Their study funded by the National Institutes of Health in the US shows that the continuous abstinence rates in the last month of treatment (51% vs 14%) and at 6-month follow-up (28% vs 7%) are higher in the varenicline group than in the placebo group. This was a 12-week trial with 6 month follow up. Treatment-emergent adverse events did not differ significantly between groups. In summary varenicline, when added to brief cessation counselling, is well tolerated and promotes nicotine vaping cessation compared with placebo in youth with addiction to vaped nicotine. This podcast is a companion to the electronic cigarettes Cochrane living systematic review and Interventions for quitting vaping review and shares the evidence from the monthly searches. Our search for the EC for smoking cessation review carried out on 1st April 2025 found 1 new ongoing study (NCT06789692) and 5 linked papers. Our search for our interventions for quitting vaping review up to 1st April 2025 found 3 new ongoing studies (NCT06862050; TCTR20250203006; NCT06885606), For further details see our webpage under 'Monthly search findings': https://www.cebm.ox.ac.uk/research/electronic-cigarettes-for-smoking-cessation-cochrane-living-systematic-review-1 For more information on the full Cochrane review of E-cigarettes for smoking cessation updated in January 2025 see: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010216.pub9/full For more information on the full Cochrane review of Interventions for quitting vaping published in January 2025 see: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD016058.pub2/full This podcast is supported by Cancer Research UK.

We talk the Pope passing, Shadeur Sanders, Shannon Sharpe, and the blockbuster movie Sinners. Listen and subscribe!!! The post We're All Sinners Now first appeared on The Poplife Podcast.

What are the 4Qs? (1) Three favorite films. (2) An underrated film. (3) An overrated film. (4) A lesser-known film people should seek out. Andy Cochrane's Immersive Short “The Carrier” played at both FI-LA and Sherman Oaks Festival to rave review and, in fact, he is largely responsible for the festivals adding a new category called “Immersive Short - AR/VR/MR/360”.  Nerding out with Andy is a happy place for me which is why Friday's interview is 2 1/2 hours long. I was definitely eager to get to his 4 Questions to see what inspired an endlessly creative talent like Andy. Make sure to visit Andrew-cochrane.com and Loud-movies.com to see the awesome things that Andy does on a regular basis. @avclubvids _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Discover Indie Film Links DIF Podcast Website - DIF Instagram - DIF BlueSky Discover Indie Film Foundation (nonprofit for the arts) Website Sherman Oaks Film Festival Film Invasion Los Angeles

Happy Friday, Everyone! Should I apologize for this 2 1/2 hour episode? Probably, but I refuse to do so because Andy Cochrane has gone from the guy who sent a random email to Sherman Oaks Film Festival with the subject, “VR Submissions,” in August of 2023 to a guy I consider my friend. Besides our many shared interests, the day I went to his studio and met Andy in person to see this VR thing, instead of my just putting on a headset we went off on a tangent about the solar panels that had just been added to my home and... the rest is (personal) history. With a LOT of help from Andy we added a new category to the festivals called “Immersive Short - AR/VR/MR/360” and this cutting edge format has been a huge hit at the festivals since we introduced them at Film Invasion Los Angeles in June of 2024.                                                                                                                                                                                                                                                                    Andy's Immersive Short “The Carrier” played at both FI-LA and Sherman Oaks Festival to rave reviews. There is a lot more to Andy than just immersive video and that's why this podcast is so dang long. Listen to it, enjoy the nerdy chatter, and make sure to visit Andrew-cochrane.com and Loud-movies.com to see the awesome things that Andy does on a regular basis. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Discover Indie Film Podcast Links DIF Podcast Website - DIF Instagram - DIF BlueSky Discover Indie Film Foundation (nonprofit for the arts) Links DIF Foundation - Sherman Oaks Film Festival - Film Invasion Los Angeles

Season 7 Episode 16: In this episode, Pete Codella, managing director of business services at the Governor's Office of Economic Opportunity, talks with Preston Cochrane, CEO of The Other Side Village.  Cochrane discusses his journey into social impact work, driven by a desire to contribute to something larger than himself. He highlights his previous roles in organizations focused on homelessness, mental health, and financial education, emphasizing the importance of believing in people's capacity for change, even when their circumstances seem overwhelming. Cochrane delves into the mission of The Other Side Village and its sister organization, The Other Side Academy. The Academy is a 2.5-year residential program for individuals with histories of incarceration, addiction, and homelessness, where residents operate social enterprises to fund the program. Inspired by the Academy's success, the Village provides permanent, supportive housing for chronically homeless individuals with mental health diagnoses. A key component of the Village is its democratic, therapeutic environment where residents are peer-led and must complete a "village prep school" before moving in. Cochrane highlights that both organizations share a core belief: people can change when supported by accountability, love, and a sense of purpose.

Happy Easter!! We talk Black Mirror, Netflix Pop The Ballon, Onijah comes home, The Jet Set tragedy, and Black folks go back to the country. Listen and spread the word!!! The post Respect To The Pod first appeared on The Poplife Podcast.

In this eye-opening episode of Healthy Waves, host Avik sits down with hypnotherapist and transformational healer Layton Fulton to explore the untapped power of the unconscious mind. From his unconventional midlife awakening to his work with hypnotherapy, engineered sound, and therapeutic psychedelics, Layton shares how releasing and reframing self-limiting beliefs can radically shift your inner and outer world. This isn't just about healing—it's about transformation, intention, and surrender. If you've ever felt stuck in patterns that no longer serve you, this episode is your invitation to begin again, with presence and curiosity.   About the Guest:Layton Fulton is a former oil and gas professional turned hypnotherapist and healing guide. After raising a family as a single father and stepping away from corporate life, he followed his inner calling into consciousness work, sound therapy, and psychedelics. Now, Layton helps clients access deep healing by integrating ancient wisdom with modern modalities. Based in Cochrane, Alberta, he works through his practice Lifecraft to help people rewire their internal narratives and embody lasting change. Key Takeaways: The unconscious mind controls 95% of your daily behavior—rewiring it is key to deep transformation. Common root beliefs like "I'm not enough" or "I'm not safe" can hold you back for decades if unexamined. Tools like hypnotherapy, NLP, sound frequency, and psychedelics help bypass resistance and unlock healing. True change begins with surrender, not force. Presence and curiosity are your most powerful tools. Community plays a vital role in sustained healing—finding your "people" starts with finding yourself. Connect with Layton Fulton:Website: https://lifecraft.caLocation: Cochrane, Alberta, Canada   Want to be a guest on Healthy Mind, Healthy Life?DM Me Here: https://www.podmatch.com/hostdetailpreview/avikSubscribe to the Newsletter: https://healthymindbyavik.substack.com/Join the Community: https://nas.io/healthymind   Stay Tuned And Follow Us!YouTube: https://www.youtube.com/@healthymind-healthylifeInstagram: https://www.instagram.com/podhealth.club/Threads: https://www.threads.net/@podhealth.clubFacebook: https://www.facebook.com/podcast.healthymindLinkedIn:https://www.linkedin.com/in/reemachatterjee/https://www.linkedin.com/in/newandnew/ #podmatch #healthymind #healthymindbyavik #wellness

Early Detection and Early Intervention - where are we now (and what does the future hold)?The last time we had Alicia on the pod, we spoke about the Cochrane Review she led titled “Early developmental intervention programmes provided post hospital discharge to prevent motor and cognitive impairment in preterm infants” which was published in 2024. In this week's episode, we thought we'd ask Alicia about the state of early intervention right now and what the provision of therapy looks like within our current context of early detection and early intervention for children with cerebral palsy.There have been some rather significant developments in the early detection and early intervention space over the past 20 years. From the rapid technological advances to the value of co-design and involvement of people with lived experience, we now have some impressive evidence to guide our clinical pathways. However, what is very clear now is the vital importance of implementation. The industry has generated substantial knowledge that now needs to be implemented into practice with one particularly important aspect that we must include - family involvement and well-being. Alicia speaks ever so passionately about our role as therapists and I cannot help but to feel even more compelled to ensure that the family is at the centre of everything we do. It is exciting to know that we have the evidence now, so it's time to put it into practice and it can start in your very next session.https://findanexpert.unimelb.edu.au/profile/27041-alicia-spittle

Stephen Serda has all the latest news from the Kansas City Chiefs and the rest of the headlines from across the NFL. Learn more about your ad choices. Visit megaphone.fm/adchoices

In the first episode of our new "Navigating Sports Media" series, Navigate's Head of Media, Umar Hussain, hosts two guests who are leading the way in the regional broadcast space.   Staring down a new local media rights reality and with just 9 months of prep time, the Texas Rangers launched Rangers Sports Network and DTC offering in partnership with Victory+. With the ongoing disruption in cable and streaming, teams will need to get creative and ensure that their content (especially games) are accessible and attractive in-market for both existing and new fans.   Jim Cochrane - Chief Business Officer at the Texas Rangers - and Jon Heidtke - Founder and Principal at Heidtke Sports Entertainment - discuss how this new strategy has put the organization in the best possible position in this new media marketplace.   Details: 2:25 - Rangers Sports Network 12:50 - Content beyond live games 15:25 - The next 5 to 10 years 18:15 - Baseball's TV product 28:05 - Rapid Fire Questions  36:55 - Umar's POV on sports media     For more insights, visit our LinkedIn page or learn more about Navigate at https://nvgt.com/.

Jamie Hartmann-Boyce and Nicola Lindson discuss emerging evidence in e-cigarette research and interview Monserrat Conde from the University of Oxford. Associate Professor Jamie Hartmann-Boyce and Associate Professor Nicola Lindson discuss the new evidence in e-cigarette research and interview Dr Monserrat Conde from the Nuffield Department of Primary Care Health Sciences, University of Oxford. In the March podcast Monserrat Conde discusses the findings of the recent systematic review of electronic cigarettes and subsequent smoking in young people and an evidence and gap map. The systematic review aims to assess the evidence for a relationship between the use of e-cigarettes /vapes and subsequent smoking in young people under 30, and whether this differs by demographic characteristics. There is very low certainty evidence suggesting that e-cigarette use and availability are inversely associated with smoking in young people (i.e. as e-cigarettes become more available and/or are used more widely, youth smoking rates go down or, conversely, as e-cigarettes are restricted, youth smoking rates go up). At an individual level, people who vape appear to be more likely to go on to smoke than people who do not vape; however, it is unclear if these behaviours are causally linked. Monserrat discusses the differences in the information coming from the population studies compared to the individual level studies and notes that most studies are from high income countries, in particular from the US. To see the full review: https://doi.org/10.1111/add.16773 This podcast is a companion to the electronic cigarettes Cochrane living systematic review and Interventions for quitting vaping review and shares the evidence from the monthly searches. Our literature searches for the EC for smoking cessation review carried out on 1st March 2025 found 1 new study (DOI: 10.1016/j.drugalcdep.2024.112271), one new ongoing study (ACTRN12625000179437) and two records linked to studies included in the review. Our literature searches for the interventions for quitting vaping review carried out on 1st March 2025 found 2 new ongoing studies (NCT06832098, ACTRN12625000143426) and four records linked to studies included in the review. For further details see our webpage under 'Monthly search findings': https://www.cebm.ox.ac.uk/research/electronic-cigarettes-for-smoking-cessation-cochrane-living-systematic-review-1 For more information on the full Cochrane review of E-cigarettes for smoking cessation updated in January 2025 see: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010216.pub9/full For more information on the full Cochrane review of Interventions for quitting vaping published in January 2025 see: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD016058.pub2/full This podcast is supported by Cancer Research UK.

Pismo Beach Today 03/23/2025 12p: Tyree Cochrane tells us about the Allen Hancock College Rodeo. Produced by Jim Richards

That KEVIN Show – March 18, 2025

We talk the Oscar’s, the Blackout, SSS4U, Love Is Blind, and Joy Reid. RIP to Ms. Voletta Wallace and Angie Stone. The post Gimmee A Podcast first appeared on The Poplife Podcast.

Polycystic Ovarian Syndrome is more common than most people realize and with more far-reaching implications than it would initially seem. Guest co-host Robyn Flynn joins Dr. Chris Labos to talk about it's potential impact on fertility, cardiovascular health, and according to Robyn, that it's more painful than childbirth?!? We're going to have to look into that one.   You can also check out Robyn's podcast, Rebel Mom Boss https://open.spotify.com/show/4uMAsJS9ySR47iGYw8ExDo?si=bc68ddfcb0bd4f3f    Become a supporter of our show today either on Patreon or through PayPal! Thank you! http://www.patreon.com/thebodyofevidence/ https://www.paypal.com/donate?hosted_button_id=9QZET78JZWCZE   Email us your questions at thebodyofevidence@gmail.com.   Editor:    Robyn Flynn Theme music: “Fall of the Ocean Queen“ by Joseph Hackl Rod of Asclepius designed by Kamil J. Przybos Chris' book, Does Coffee Cause Cancer?: https://ecwpress.com/products/does-coffee-cause-cancer   Obviously, Chris not your doctor (probably). This podcast is not medical advice for you; it is what we call information.   References: 1) Dutch Twin study about the role of genetics in PCOS:   10.1210/jc.2005-1494   2) Cochrane review on meds that improve fertility https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003053.pub6/full   3) RCT of diet to restore fertility https://academic.oup.com/jcem/article-abstract/88/2/812/2845309?redirectedFrom=fulltext   4) Benefits of weight loss prior to fertility treatment 10.1210/jc.2016-1659 5) Letrozole vs. clomiphene for fertility treatment https://www.nejm.org/doi/full/10.1056/NEJMoa1313517 6) Metformin as a fertility treatment 10.1001/jamanetworkopen.2020.11995  

Listen and spread the word….. The post I Can Fit!! first appeared on The Poplife Podcast.

We talk Closed Captioning on Instagram, Grammy Recap, Irv Gotti, Hillman Tik Tok, Black lady in Pakistan, and the Lisa Lisa tv movie. Listen and spread the word!! The post I'm Minding My Business, Thank You first appeared on The Poplife Podcast.

We talk HillmanTok, Snoop Dogg Tabitha Brown, Love And Marriage Huntsville, and plane crashes… Thank you for listening… The post Y'all Do Your Homework? first appeared on The Poplife Podcast.

2nd hour of the G-Bag Nation: NFL News of the Day; Texas Rangers Chief Revenue Officer Jim Cochrane joins the Nation to talk Rangers new broadcasting network; Crusty's Corner: Senior Bowl takeaways full 2478 Thu, 30 Jan 2025 00:08:31 +0000 lr9qd0NfNQHyqCHeZ61WXyfTNVUaXlS2 sports GBag Nation sports 2nd hour of the G-Bag Nation: NFL News of the Day; Texas Rangers Chief Revenue Officer Jim Cochrane joins the Nation to talk Rangers new broadcasting network; Crusty's Corner: Senior Bowl takeaways The G-Bag Nation - Weekdays 10am-3pm 2024 © 2021 Audacy, Inc.